The use of melatonin in oxidative stress diseases of the newborn

Melatonin, a hormone primarily secreted by the pineal gland, has emerged as a promising therapeutic agent in neonatology due to its potent antioxidant, antiinflammatory, and neuroprotective properties. Beyond its well-established role in circadian rhythm regulation, melatonin exerts pleiotropic effects, including immune modulation, vascular regulation, and free radical scavenging. In neonates, particularly if preterms, melatonin production is limited, increasing susceptibility to oxidative stress and related complications. This chapter explores the physiological functions of melatonin and its clinical implications in neonatal conditions such as sepsis, bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis, and complications following surgery. Evidence from experimental and preliminary clinical studies suggests that melatonin supplementation may reduce inflammation, oxidative damage, and disease severity in these contexts. Its role in pregnancies complicated by fetal growth restriction and preeclampsia is also discussed. While melatonin appears safe and well-tolerated in neonates, further large-scale trials are needed to determine optimal dosing and confirm long-term safety and efficacy. Overall, melatonin represents a compelling candidate for adjunctive therapy in neonatal care. © 2026 Elsevier Inc. All rights reserved.