Perinatal oxidative stress and bone development in the first year of life: a preliminary study using REMS

Background Oxidative stress has been implicated in impairing tissue development, but its impact on early postnatal skeletal growth in humans remains poorly understood. This study investigates the relationship between perinatal redox status and bone development during infancy, using Radiofrequency Echographic Multi Spectrometry (REMS), a non-invasive, radiation-free technology for bone quality assessment. Methods A longitudinal observational study on a cohort of healthy, full-term neonates (n=65, 29 females and 36 males) was conducted. Total antioxidant capacity (TAC) and markers of protein and DNA oxidation (advanced oxidation protein products (AOPP); 8-hydroxy-2′-deoxyguanosine (8OH-dG)) were measured in arterial cord blood at birth. Auxological parameters were collected at birth and during follow-up visits at 1, 3, 6, and 12 months. Bone quality was assessed using REMS at 3, 6, and 12 months, and results were expressed as age-adjusted Z-scores. Results Cord blood TAC levels showed a significant positive correlation with birth weight (r=0.51, p<0,001), length (r=0.40, p=0.0013), and birth head circumference (r=0,42, p=0,0017). Statistical positive correlations were also found between cord blood TAC and length and weight a 1 month of age (r=0.51, p<0.001; r=0.36, p=0.0067). In contrast, higher levels of oxidative damage were inversely associated with REMS-derived Z-scores at both 6 and 12 months of life (8OH-dG vs REMS-derived Z-scores at 6 months (r=-0.23, p= 0.02), and AOPP vs REMS-derived Z-scores at 12 months (r=-0.33 p=0.022; r=-0.64, p<0.001, respectively). REMS Z-scores also showed strong internal consistency across timepoints (3 vs 6 months, r=0.53, p<0.001,; 6 vs 12 months, r=0.29, p=0.046). A significant correlation was observed between REMS Z-score and head circumference at 3 months (r=0.48, p<0.001). Conclusions Our findings suggest that perinatal oxidative balance plays a critical role in early longitudinal growth. REMS appears to be a reliable tool for tracking bone quality in infancy, with potential for future applications in pediatric bone health monitoring. Although limited to healthy infants born from physiological pregnancies, this study provides foundational data in a largely unexplored area and supports the hypothesis that fetal redox status may influence lifelong skeletal outcomes.