Markers of Oxidative Stress in Obstetrics and Gynaecology—A Systematic Literature Review

Abstract

Oxidative stress has been implicated in many diseases, including reproductive and pregnancy disorders, from subfertility to maternal vascular disease or preterm labour. There is, however, discrepancy within the standardized markers of oxidative stress in obstetrics and gynaecology in clinical studies. This review aims to present the scope of markers used between 2012 and 2022 to describe oxidative stress with regard to reproduction, pregnancy, and pregnancy-related issues. Despite the abundance of evidence, there is no consensus on the set of standardised markers of oxidative stress which poses a challenge to achieve universal consensus in order to appropriately triangulate the results.

Oxidative Stress in Pregnancy

“…An array of markers is employed to describe OS, encompassing MDA, nitric oxide (NO), ROS, TAC, total antioxidant activity (TAA), SOD, GPx, glutathione peroxidase-4 (GPx4), glutathione reductase (GR), LPO, 8-hydroxydeoxyguanosine (8-OHdG), oxidized glutathione (GSSG), CAT, superoxide (O 2 -), paraoxonase (PON-1), oxidative stress index (OSI), high-sensitivity C-reactive protein (hs-CRP), 8-iso-prostaglandin F2α (8-iso-PGF2α), prostaglandin F2α (PGF2α), GSH, and glutathione transferase (GST). These markers are analyzed using various materials, primarily blood (serum or plasma) and placenta, along with urine, Wharton's jelly mesenchymal stem cells derived from the umbilical cord, and saliva [189,190].…”

“…Therefore, the authors suggest that TOS and TAS levels may serve as additional markers for the diagnosis and assessment of the clinical severity of NVP. In addition, Drejz et al [189], based on an analysis of 83 selected papers, recommend the establishment of a common core panel of OS markers to be used in all studies related to OS in obstetrics and gynecology. They suggest including ROS as a direct marker of OS, 8-OHdG as a marker of DNA/RNA damage, and MDA as a marker of LPO.…”

The Impact of Follicular Fluid Oxidative Stress Levels on the Outcomes of Assisted Reproductive Therapy

“…Therefore, markers such as malondialdehyde (MDA), lipid peroxidation (LPO), advanced oxidation protein products (AOPP), and 8-OHdG are commonly used to assess oxidative damage. Michalina et al compiled studies from 2012 to 2022 in the field of female reproduction and identified the most commonly used oxidative stress markers in female reproduction as ROS, 8-OHdG, MDA, TAC, and glutathione (GSH) [21]. Research by Iman et al suggested that oxidative stress biomarkers such as 8-OHdG, TAC, and MDA are associated with reproductive hormones and ART pregnancy outcomes, potentially serving as valuable tools for evaluating clinical characteristics in IVF patients [22].…”

Disrupted Balance of the Oxidant–Antioxidant System in the Pathophysiology of Female Reproduction: Oxidative Stress and Adverse Pregnancy Outcomes

“…Important examples of the latter include polycystic ovary syndrome (PCOS) and endometriosis, conditions that signal organ dysfunction associated with infertility risk. The pathophysiology of the most important obstetric complications including preeclampsia (PE), gestational diabetes mellitus (GDM) and intrauterine growth restriction (IUGR) nearly always involves placental OS; in addition, oxidant vs. antioxidant imbalance with oxidant predominance also increases the risk for habitual abortion and premature delivery [17][18][19].…”