Antioxidants and Oxidative Stress: Focus in Obese Pregnancies

Abstract

The prevalence of obesity in women of childbearing age around the globe has dramatically increased in the last decades. Obesity is characterized by a low-state chronic inflammation, metabolism impairment and oxidative stress, among other pathological changes. Getting pregnant in this situation involves that gestation will occur in an unhealthy environment, that can potentially jeopardize both maternal and fetal health. In this review, we analyze the role of maternal obesity-induced oxidative stress as a risk factor to develop adverse outcomes during gestation, including reduced fertility, spontaneous abortion, teratogenesis, preeclampsia, and intrauterine growth restriction. Evidences of macromolecule oxidation increase in reactive oxygen species generation and antioxidant defense alterations are commonly described in maternal and fetal tissues. Thus, antioxidant supplementation become an interesting prophylactic and therapeutic tool, that yields positive results in cellular, and animal models. However, the results from most meta-analysis studying the effect of these therapies in complicated gestations in humans are not really encouraging. It is still to be analyzed whether these therapies could work if applied to cohorts of patients at a high risk, such as those with low concentration of antioxidants or obese pregnant women.

Placental Adaptive Changes to Protect Function and Decrease Oxidative Damage in Metabolically Healthy Maternal Obesity

“…In relation to other pregnancy-associated disorders, a reduced enzymatic capacity and increased oxidation has been demonstrated in placenta tissue from preeclamptic women, contributing to the pathogenesis of this gestational disorder [49]. On the other hand, increased oxidative stress in late gestation was observed in several pregnancy-related disorders in association with increased trophoblast apoptosis and altered placental vascular endothelium [50]. Meanwhile, other promising studies have revealed the presence of possible alterations in ROS/SOD ratio based on upregulation of the SOD along with the activation of the superoxide anion degradation pathway at the vascular level in cardiovascular diseases [51].…”

Evaluation of carcinoembryonic antigen‐related cell adhesion molecule 1 blood serum levels in women at high risk for preeclampsia

“…The prevalence of obese pregnant women has steadily increased worldwide in recent years 34 . Obesity leads to pregnancy development under suboptimal conditions because of chronic inflammation, oxidative stress, metabolic insufficiency, and insulin resistance 35 . The chronic inflammation caused by obesity deregulates the immune tolerance between mother and fetus, and it could be a possible explanation for the increased sCEACAM1 concentration in high‐risk patients.…”

Prevention of Teratogenesis in Pregnancies of Obese Rats by Vitamin E Supplementation

“…The importance of these numbers lies in the fact that pregestational obesity has been linked to an increased risk of adverse outcomes at every stage of pregnancy, including periconceptional difficulties and health consequences in the newborn [ 3 , 4 , 5 , 6 , 7 ]. During gestation, obese mothers have a higher risk of spontaneous and recurrent pregnancy loss [ 8 ], preeclampsia and gestational diabetes mellitus [ 9 ].…”

“…Oxidative stress (OS) has been proposed as a common underlying mechanism for malformations induced by either maternal diabetes or obesity [ 7 , 18 , 19 ]. Both obesity and pregnancy are, per se , situations characterized by an imbalance between the production of reactive oxygen species and their elimination by antioxidant defenses.…”

“…However, the beneficial effects of additional supplementation is controversial [ 31 , 32 ]. However, there are insufficient data regarding the supplementation of vitamin E alone in mothers with pregestational obesity [ 7 ]. We have shown that vitamin E improves the metabolic, inflammatory and oxidative profiles in a mouse model of diet-induced obesity [ 33 ].…”