Asian Journal of Clinical Perinatology and Pediatric Biology

Volume 1 (2026)
Published : Feb 7, 2026

Oxidative Stress Signatures in Umbilical Cord Blood and Early Neonatal Adaptation

Nirmala Palayathan (1), Harini Narayanam (2), Gaayatree Rao N (3)

(1) School of Medicine, Perdana University, Damansara Heights, Kuala Lumpur, Malaysia
(2) Department of Physiology, Faculty of Medicine, Manipal University College, Malaysia
(3) School of Medicine, Perdana University, Damansara Heights, Kuala Lumpur, Malaysia
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Abstract

Oxidative stress is an unavoidable part of the neonatal transition from intrauterine to extrauterine life caused by the change in exposure to oxygen at birth. This study explores the possibility of oxidative stress signatures in umbilical cord blood being adaptive biomarkers of the neonatal transition. Using multivariate temporal and network based analytic methods, I analyzed the umbilical cord blood redox profiles damage in the blood and the redox enzymes to oxidative stress to determine the inter-individual heterogeneity at birth. A variety of redox profiles were determined and a non-linear relation was found between the burden of oxidative stress and the indices of transition, which included the stabilization of the cardiopulmonary system and thermoregulation. Model time resolution brought to light antioxidant differential recovery pathways within the first three post-natal days (72 hours). Co-ordinated antioxidant buffering mechanisms were centered on networks at the level of post-oxygen species and this was demonstrated in the network level analysis. Further, the predictive classification model indicated that redox profiles of cord blood umbilical veins successfully defined strata for the neonatal adaptation risk with significant separation along the primary oxidative-antioxidant axis. Overall, the results indicate that oxidative stress signatures in umbilical cord blood can serve as integrative signatures of neonatal adaptation with potential value for early risk stratification and postnatal monitoring.

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