Abstract-Preeclampsia remains a frequent and potentially dangerous complication of pregnancy. The cause remains largely unknown, but oxidative stress and a generalized inflammatory state are features of the maternal syndrome. The placenta appears to be the principal source of free radical synthesis but maternal leukocytes and the maternal endothelium are also likely contributors. Recent reports have suggested an important role for placental trophoblast NAD(P)H oxidase in free radical generation in preeclampsia. The antioxidant vitamin E is now known to have multiple actions in addition to prevention of lipid peroxidation (ie, inhibition of NAD(P)H oxidase activation and the inflammatory response). In view of the abnormally low plasma vitamin C concentrations in preeclampsia, a combination of vitamins C and E is a promising prophylactic strategy for prevention of preeclampsia. Key Words: preeclampsia Ⅲ oxidative stress Ⅲ antioxidants Ⅲ free radicals P reeclampsia affects between 0.4% and 2.8% of all pregnancies in developed countries and many more in developing countries, leading to as many as 8 370 000 cases worldwide per year. 1 This common disorder, which is more prevalent in first pregnancies, is associated with the highest maternal and fetal morbidity and mortality of all pregnancy complications, with Ͼ90% of the most serious outcomes occurring in developing countries. 1 According to the criteria of the International Society of the Study of Hypertension in Pregnancy, the preferred definition is a diagnosis of pregnancy-induced hypertension (diastolic blood pressure Ͼ90 mm Hg) occurring after week 20 of gestation with proteinuria (either Ն300 mg protein per day or an urinary protein/creatinine ratio Ն30 mg/mmol). 2 When patients have liver dysfunction, thrombocytopenia, and hemolysis, they are classified as having HELLP syndrome (ie, hemolysis, elevated liver enzymes, low platelets). 3 Although the definitions focus on these simply measured clinical parameters, preeclampsia must be recognized as a multisystem disorder, which variably may affect the brain, lungs, kidney, and liver.The risk of preeclampsia markedly increases in women with previous preeclampsia and in those with either preexisting vascular disease or conditions associated with increased cardiovascular risk, including renal disease, hypertension, diabetes, thrombophilia, and obesity (body mass index Ͼ29). 4 Additionally, occurrence in first-degree relatives increases the risk. Thus preeclampsia also has a hereditary origin, but inheritance does not follow simple Mendelian characteristics and a single "preeclampsia gene" is unlikely. Despite intensive effort, associations with polymorphisms of likely candidate genes, mostly associated with cardiovascular disease, have been weak, inconsistent, or negative. 5 Women who have had preeclampsia are also at greater risk for cardiovascular disease in later life, 6,7 and pregnancy, itself a transient state of the metabolic syndrome, is considered to represent a "stress test" that unmasks latent cardiovascu...
