Oxidative stress markers in severe preeclampsia and preeclampsia-related perinatal morbidity — preliminary report

Abstract

Objectives: The aim of the study was to determine maternal serum total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), paraoxonase (PON) and arylesterase levels in severe preeclamptic pregnants and also to investigate whether these parameters are implicated in the occurence of perinatal morbidity or not. Material and methods:A case-control study was carried out including 60 pregnant women (30 with severe preeclampsia and 30 healthy controls). The optimal cut off points of oxidative stress markers for the diagnosis of severe preeclampsia and for the prediction of adverse perinatal outcomes were evaluated by receiver operating characteristic (ROC) analyses. Multivariate logistic regression analysis was used to determine if a relationship between adverse perinatal outcomes and serum oxidative stress markers was present or not.Results: TAS (OR = 37.486, 95% CI 3.535-397.519, p = 0.003), TOS (OR = 15.588, 95% CI 2.135-113.818, p = 0.007) and arylesterase (OR = 31.356, 95% CI 2.284-430.548, p = 0.01) were found to be diagnostic for preeclampsia. Statistically significant positive correlation of adverse perinatal outcomes with serum TAS, PON and arylesterase levels were determined. Besides, a significant negative correlation was found between serum TAS levels and gestational week (r = -0.342, p = 0.007) and also between serum PON levels and birthweight (r = -0.262, p = 0.043). Conclusions:Increased maternal serum TAS, TOS and arylesterase levels are significantly associated with the presence of severe preeclampsia. Furthermore, elevated maternal serum TAS, PON and arylesterase levels are significantly and positively correlated with adverse perinatal outcomes. We suggest that in preeclampsia increased oxidative status may cause adverse perinatal outcomes and antioxidants may be increased in order to protect the fetus against oxidative damage.

The diagnostic potential of oxidative stress biomarkers for preeclampsia: systematic review and meta-analysis

“…Nevertheless, the studies included in the meta-analysis related to IMA, UA, and MDA were all consistent with low heterogeneity. Through our search, we also identified other oxidative stress biomarkers including total antioxidant status, total oxidant status, and oxidative stress index, however, the outcomes of these studies were not related to preeclampsia only but included other endpoints such as HELLP syndrome or neurological development [ 43 , 59 , 60 ]. Also, we were unable to obtain a sufficient number of studies (i.e., n < 3) for many biomarkers including total thiol, native thiol, and disulfide, which meant that we could not perform meta-analysis on these.…”

Afamin: an early predictor of preeclampsia

“…Oxidative stress, however, seems to be a concomitant factor in metabolic syndrome, IR and PCOS [ 31 – 33 ]. It was already demonstrated that preeclampsia is a status of elevated oxidative stress [ 10 , 34 ]. Additionally, patients with placental dysfunction are at high risk to develop metabolic syndrome, IR [ 8 ] and cardiovascular disease later in their life [ 35 ].…”

The possibility of clinical use for the oxidative stress marker in correlation with blood flow parameters in pregnancy-induced hypertension

“…There are several studies in the literature, which show that oxidative stress is extremely high in PIH and that it is in direct positive correlation with values of blood pressure level -with the highest levels of BP, the highest are TBARS values as an oxidative stress marker [10,11,27].…”

“…Free radicals can alter biomolecules, including the unsaturated fatty acids; deoxyribonucleic acid, ribonucleic acid. More recently, great attention has been paid to lipid peroxidation that involves the unsaturated fatty acids and generates several harmful products including malondialdehyde (MDA) [10][11][12]. MDA is the main product of lipid peroxidation and an indicator of oxidative stress.…”