Role of oxidative stress and antioxidant supplementation in pregnancy disorders (original) (raw)
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A Study of Oxidative Stress In Preeclampsia
Biosciences Biotechnology Research Asia, 2012
Preeclampsia is a pregnancy specific syndrome of reduced organ perfusion secondary to vasospasm and endothelial activation. A number of reports indicate that preeclampsia is associated with elevated blood levels of lipid peroxidation products. The present study was undertaken to evaluate the metabolic correlation between preeclampsia and oxidative stress. 95 no of subjects was selected out for the study out of which normal nonpregnant control group had 25 subjects, normal pregnant control group had 40 subjects & preeclampsia group constituted of 30 subjects. The investigations included are serum lipid profile consisting of serum total cholesterol, serum triglycerides, VLDL, LDL and HDL, serum vitamin E as á-tocopherol and malondialdehyde. There is significant increase in serum triglyceride, serum cholesterol along with LDL and VLDL (p<0.0001) in pregnancy over nonpregnant controls and preeclampsia over pregnant control (p<0.0001). It is observed that in normal controls without pregnancy there is no relationship between serum vitamin E and serum lipid peroxidation as represented by whole blood MDA (malondialdehyde) with a correlation coefficient of 0.13 only. In contrast to this, under the condition of normal pregnancy and preeclampsia the correlation between these two parameters increased with coefficients of correlation (r =-0.9) with a negative trend indicating a definite and significant degree of inverse relationship between two. It is finally proposed that adequate vitamin E supplementation during pregnancy with proportionate increase in preeclampsia may reduce the consequences of peroxidation induced complications during pregnancy.
Assessment of oxidative stress markers and level of antioxidant in preeclampsia
IP innovative publication pvt. ltd, 2019
Introduction: In pre-eclampsia the pathophysiology is still under investigation. Lipid peroxidation is important for the normal endothelial cell function. The antioxidant like Vitamin E and vitamin C play a role in preventing preeclampsia. Materials and Methods: We compare between serum malondialdehyde (MDA) level, a product of lipid peroxide and the antioxidant (vitamin C and E) in pregnant women with or without preeclampsia. Patient are divided to two group; Group 1 (n=50): pregnant women between 28 and 40 weeks’ gestation with preeclampsia and Group 2(n=50): the control group includes pregnant women without hypertension episode during their pregnancy. Result: Serum MDA levels were raised in women with preeclampsia compared with normal pregnancy (P < 0.001*). A positive correlation was seen between MDA level and both systolic and diastolic blood pressure in preeclamptic and normal pregnancies (rs = 0.693, p<0.001*), (rs =0.467, p<0.001*) respectively. Vitamin C, E level show s highly significant decrease in Pre-eclamptic women than normal one (p<0.001*). Significant negative correlation between vitamin C level (mg/dl) and both systolic blood pressure and diastolic blood pressure (P<0.001*, p<0.018*) respectively. Significant negative correlation between vitamin E level (mg/dl) and both systolic blood pressure and diastolic blood pressure (P <0.05), (P <0.05) respectively. Conclusion: These results provide further evidence that excessive lipid peroxidation level and decreases in vitamin E and C levels (which are responsible from antioxidant activity) may contribute to the pathophysiology and pathogenesis of preeclampsia.
Pharmacology & Therapeutics, 2005
Preeclampsia (PE) is a multisystem disorder that remains a major cause of maternal and foetal morbidity and death. To date, no treatment has been found that prevents the development of the disease. Endothelial dysfunction is considered to underlie its clinical manifestations, such as maternal hypertension, proteinuria, and edema; however, the precise biochemical pathways involved remain unclear. A current hypothesis invokes the occurrence of oxidative stress as pathogenically important, as suggested by the fact that in PE, the placental and circulating levels of lipid peroxidation products (F2-isoprostanes and malondialdehyde [MDA]) are increased and endothelial cells are activated. A potential mechanism for endothelial dysfunction may occur via nuclear transcription factor kappa B (NF-nB) activation by oxidative stress. Alternatively, the idea that the antiangiogenic placental soluble fms-like tyrosine kinase 1 factor (sFlt1) is involved in the pathogenesis of this disease is just emerging; however, other pathophysiological events seem to precede its increased production. This review is focused on evidence providing a pathophysiological basis for the beneficial effect of early antioxidant therapy in the prevention of PE, mainly supported by the biological effects of vitamins C and E.
A Comparative Study of Oxidative Stress in Preeclampsia and Normal Pregnancy
Article, 2020
Objectives: Pre-eclampsia is a human pregnancy-specific disorder. It is an important cause of maternal mortality in Sokoto, Northwestern Nigeria and is associated with a five-fold increase in perinatal mortality. Identifying modifiable factors to decrease oxidative stress in the pregnant woman's environment may be an inexpensive and non-invasive therapy for decreasing the maternal and foetal morbidity and mortality associated with preeclampsia. This study aimed at comparing the levels of 3 oxidative stress markers; glutathione peroxidase (GPX), superoxide dismutase (SOD), and malondialdehyde (MDA) and 4 antioxidants (Catalase, Vitamins A, C and E) in normotensive and preeclamptic pregnant women in Sokoto. Methodology: This was a prospective cross-sectional study of 199 normotensive and 201 preeclamptic women attending the antenatal clinics or admitted to the pre-eclamptic/eclamptic wards of Usmanu Danfodiyo University Teaching Hospital, Sokoto or Specialist Hospital Sokoto. Structured questionnaires were administered and relevant information obtained. Blood samples were obtained by standard laboratory techniques and assayed for the oxidative stress markers and antioxidants. Statistical analysis was by GraphPad InStat Software (version 3.0) San Diego, USA. Results: The mean levels of oxidative stress markers MDA and GPX were increased in the preeclamptic women (3.44±1.25 and 71.53 ± 26.02) when compared to controls (3.024±1.08 and 62.58 ± 22.45) respectively (p=0.00) while SOD was decreased in the cases (13.00±15.27) when compared to the controls (57.21 ± 38.08) p=0.00. The antioxidant Vitamins A and C were significantly decreased in the preeclamptic women (1.52±1.68 and 0.14±1.33) p=0.00 while Catalase was increased (50.93±36.22; p=0.00). Conclusion: The results of this study are in agreement with most previous studies which showed that markers of lipid peroxidation were increased in the plasma of women with preeclampsia. Follow-up studies, are needed to enable us arrive at the certain conclusion that interventions with antioxidants and vitamins may be the panacea to this disease in our sub-region.
Antioxidant therapy to prevent preeclampsia: a randomized controlled trial
Obstetrics and gynecology, 2007
To study whether antioxidant supplementation will reduce the incidence of preeclampsia among patients at increased risk. A randomized, placebo-controlled, double-blind clinical trial was conducted at four Brazilian sites. Women between 12 0/7 weeks and 19 6/7 weeks of gestation and diagnosed to have chronic hypertension or a prior history of preeclampsia were randomly assigned to daily treatment with both vitamin C (1,000 mg) and vitamin E (400 International Units) or placebo. Analyses were adjusted for clinical site and risk group (prior preeclampsia, chronic hypertension, or both). A sample size of 734 would provide 80% power to detect a 40% reduction in the risk of preeclampsia, assuming a placebo group rate of 21% and alpha=.05. The alpha level for the final analysis, adjusted for interim looks, was 0.0458. Outcome data for 707 of 739 randomly assigned patients revealed no significant reduction in the rate of preeclampsia (study drug, 13.8% [49 of 355] compared with placebo, 15....
Impaired antioxidant activity in women with pre-eclampsia
International Journal of Gynecology & Obstetrics, 1999
Objecti¨e: To investigate antioxidant activity of sera and the plasma blood levels of two potent antioxidant in women with pre-eclampsia and normotensive pregnancies. Study design: The antioxidant activity of sera and the Ž . blood levels of ascorbic acid and ␣-tocopherol were assayed in women with normal pregnancies n s 33 , mild Ž . Ž . pre-eclampsia n s 8 , and severe pre-eclampsia n s 16 between 20 and 40 weeks' gestation. Ascorbic acid and ␣-tocopherol concentrations were analyzed by high-performance liquid chromatography. Antioxidant activity of sera was measured as the percent inhibition of spontaneous autoxidation of a standard brain homogenate. Results: Plasma levels of ascorbic acid in women with mild and severe pre-eclampsia were significantly lower than normal pregnancies Ž . Ž . P -0.05 . Sera ␣-tocopherol levels were significantly decreased only in severe pre-eclampsia P-0.05 . Sera Ž . Ž . antioxidant activity were significantly decreased in mild 73% and severe 51% pre-eclampsia compared with Ž . Ž . normal 86% pregnancies Ps 0.02, Ps 0.000, respectively . Conclusions: In women with pre-eclampsia, sera antioxidant activity and antioxidant level of plasma are decreased when compared with normotensive pregnancies. Impaired antioxidant activity and the reduction of antioxidant levels which increase the level of lipid peroxidation products may cause peroxidative damage of vascular endothelium and result in clinical symptoms of pre-eclampsia. ᮊ 1999 International Federation of Gynecology and Obstetrics.
Effect of Antioxidants on the Occurrence of Pre-eclampsia in Women at Increased Risk
The objective of this work is: Asses the potential benefit of antioxidant supplementation on the occurrence of preeclampsia at high risk women. Patients and Methods: The number of primigravida women's collected was " 294" with gestational age ranged from 18-22 wks. .from (294) prim gravida cases ,(25) women were identified as being at increased risk of pre-eclampsia by abnormal Doppler wave form in either uterine artery at 18-22 weeks' gestation (defined as a resistance index < 95th centile for gestation or the presence of an early diastolic notch) , Another (25) women with history in the preceding pregnancy of pre-eclampsia, eclampsia or HELLP (Hemolysis, elevated liver enzymes, low platelets) .-Total number of eligible participants were, (50) cases. Design and procedure: Cases divided randomly into two groups each 25 cases one group received tablets of 1000 mg vitamin C, (Cevitil efferecent. EPICO) + 400 iu of vitamin E (E-Viton 400 pharco). Venous blood for measurement of PAI-1 and PAI-2, The primary outcome measure was the ratio PAI-1 / PAI-2 and the secondary outcome prospectively according to guidelines of international society for the study of hypertension in pregnancy. Results: Doppler screening was done on, 294 prim gravidae with gestational age ranged from 18-22 weeks; only 42 women showed abnormal Doppler study so asked to come for rescanning at 24 weeks' gestation. 31 out of 42 patients (75%) have persistent abnormal study. The remainders of the 42 women (25%) were withdrawn from the study at 24 wks.' gestation because they have normal uterine-artery scan. Development of mild preeclampsia was statistically lower (p<0.5) in the study than that in the control group. However, development of sever preeclampsia or superimposed preeclampsia was statistically insignificant between both groups. PAI-1 was significantly increased in women developed preeclampsia more than normotensive (167±71.2, 113.8±35.6ng/ml respectively) with P=0.03 IN contrast PAI-2 was significantly decreased in women developed preeclampsia less than normotensive (105±34.9, 181.1±67.9ng/ml respectively) with P=0.018. Conclusion: Treatment and prevention trials of preeclampsia have been disappointing to date. However, this study has suggested causal links between oxidative stress and the development of preeclampsia indicate that may be a role for antioxidant vitamins in the prevention of preeclampsia. a high-risk population can be successfully identified on the basis of uterine-artery Doppler screening and pervious history of the disease. By/ Mahmoud. A. Sultan1, Hassan Salim1, Y. Elmesallawy 1, E.A.Eltamamy 1, Ibrahim Arafa 2. 1 Professor at Al Azhar University, faculty of Medicine, Obstetrics and Gynaecology Dept. Egypt. 2 MD. Al Azhar University Faculty of Medicine Obstetrics and Gynaecology Dept. Egypt