Levels of lipid peroxides in uncomplicated pregnancy: a review of the literature

Is human labor at term an inflammatory condition?†

Parturition at term in normal pregnancy follows a predictable sequence of events. There is some evidence that a state of inflammation prevails in the reproductive tissues during labor at term, but it is uncertain whether this phenomenon is the initiating signal for parturition. The absence of a clear temporal sequence of inflammatory events prior to labor casts doubt on the concept that normal human labor at term is primarily the result of an inflammatory cascade. This review examines evidence linking parturition and inflammation in order to address whether inflammation is a cause of labor, a consequence of labor, or a separate but related phenomenon. Finally, we identify and suggest ways to reconcile inconsistencies regarding definitions of labor onset in published research, which may contribute to the variability in conclusions regarding the genesis and maintenance of parturition. A more thorough understanding of the processes underlying normal parturition at term may lead to novel insights regarding abnormal labor, including spontaneous preterm labor, preterm premature rupture of the fetal membranes, and dysfunctional labor, and the role of inflammation in each.

Pathogenesis of Congenital Malformations: Possible Role of Oxidative Stress

OBJECTIVE

Congenital anomalies are important causes of morbidity and mortality in children. Oxidative stress (OS) is involved in the physiopathology of pregnancy-related congenital malformations. This review summarizes the role of OS in the pathogenesis of congenital malformations; in particular, its purpose is to describe how OS influences the development of heart congenital malformations, oesophageal atresia, biliary atresia, diaphragmatic hernia, and autosomal dominant polycystic kidney disease.

STUDY DESIGN

Systematic review of previous studies about the role of OS in pregnancy and its possible effects in developing of congenital malformations. One electronic database (PubMed) was searched and reference lists were checked.

RESULTS

An imbalance between the production of reactive oxygen species (ROS) and antioxidant defense can occur early in pregnancy and continue in the postnatal life, producing OS. It may destroy the signaling pathways needed for a correct embryogenesis leading to birth defects. In fact, cell functions, especially during embryogenesis, needs specific signaling pathways to regulate the development. These pathways are sensitive to both endogenous and exogenous factors; therefore, they can produce structural alterations of the developing fetus.

CONCLUSION

Because OS plays a significant role in pathogenesis of congenital malformations, studies should be developed in order to better define their OS mechanisms and the beneficial effects of supplemental therapeutic strategies.

KEY POINTS

· Oxidative stress is involved in the pathogenesis of congenital malformations.. · Heart malformations, oesophageal atresia, biliary atresia, diaphragmatic hernia, and autosomal dominant polycystic kidney are analyzed.. · A knowledge of pathomechanism of OS-related congenital malformations could be useful to prevent them..

Fetal programming of human energy homeostasis brain networks: Issues and considerations

In this paper, we present a transdisciplinary framework and testable hypotheses regarding the process of fetal programming of energy homeostasis brain circuitry. Our model proposes that key aspects of energy homeostasis brain circuitry already are functional by the time of birth (with substantial interindividual variation); that this phenotypic variation at birth is an important determinant of subsequent susceptibility for energy imbalance and childhood obesity risk; and that this brain circuitry exhibits developmental plasticity, in that it is influenced by conditions during intrauterine life, particularly maternal-placental-fetal endocrine, immune/inflammatory, and metabolic processes and their upstream determinants. We review evidence that supports the scientific premise for each element of this formulation, identify future research directions, particularly recent advances that may facilitate a better quantification of the ontogeny of energy homeostasis brain networks, highlight animal and in vitro-based approaches that may better address the determinants of interindividual variation in energy homeostasis brain networks, and discuss the implications of this formulation for the development of strategies targeted towards the primary prevention of childhood obesity.

Redox status of pregnant women with thrombophilia

Background/Aim. Since the role of oxidative stress in the pathogenesis of thrombophilia in pregnancy has still not been clarified, the aim of the study was to assess the redox status of pregnant women with thrombophilia. Methods. The study involved 120 pregnant women divided into two groups: pregnant women with thrombophilia (n = 60) and women with normal pregnancy (n = 60). Blood samples for biochemical analysis were collected at the end of the first, second, and third trimester of pregnancy. Concentrations of hydrogen peroxide (H2O2), nitrites (NO2-), and the index of lipid peroxidation measured as thiobarbituric acid reactive substances (TBARS) were measured in plasma. Levels of reduced glutathione (GSH), activities of superoxide dismutase (SOD) and catalase (CAT) were measured in erythrocytes. Results. In women with thrombophilia, NO2- values were increased in the first and third trimester compared to healthy pregnant women (p < 0.05). The higher levels of TBARS and H2O2 were noticed in women with thrombophilia in the first trimester compared to healthy pregnant women (p < 0.05). The values of SOD and CAT were lower in women with thrombophilia in the third and GSH in the first trimester compared to the control group (p < 0.05). Conclusion. Our results suggest an increased generation of prooxidants in thrombophilia at the beginning of gestation, which declines as gestation progresses and reaches similar values as in normal pregnancy at the end of pregnancy. Generally viewed, pregnant women with thrombophilia was associated with impaired antioxidant capacity ? activities of SOD and CAT were lower in the third and GSH in the first trimester compared to their values in healthy pregnant women.

Effects of the anesthesia technique used during cesarean section on maternal-neonatal thiol disulfide homeostasis

BACKGROUND

Thiols are organic compounds consisting of a sulfhydryl group which exerts antioxidant effects via dynamic thiol-disulfide homeostasis (TDH). The shift towards the disulfide states signals an oxidative situation. Maternal-neonatal oxidative stress can be affected by the anesthetic technique used during cesarean section. This study aimed to evaluate the relationship between the type of anesthesia used and the maternal-neonatal TDH.

METHODS

ASA I-II, term parturients undergoing elective cesarean section either under general (Group G) or spinal (Group S) anesthesia were included. Blood specimens were collected preoperatively and postoperatively from the mothers and from the umbilical venous cords at delivery. TDH was studied by a new method developed by the authors (O.E. and S.N.).

RESULTS

Postoperative mother's native thiol, total thiol, disulfide/total thiol, native thiol/ disulfide and disulfide levels were higher in Group G than in Group S. There was no significant difference between the groups in umbilical venous cord albumin, native thiol/total thiol, disulfide, native thiol/ disulfide and total thiol/ disulfide. However, in Group G, umbilical venous cord native thiol and total thiol levels were statistically significantly lower than those in Group S.

CONCLUSIONS

Our results showed that general anesthesia in cesarean section leads to an impairment in TDH when compared with spinal anesthesia. Oxidative stress might be modified by the preferred anesthetic technique.

The Mitochondrion as Potential Interface in Early-Life Stress Brain Programming

Mitochondria play a central role in cellular energy-generating processes and are master regulators of cell life. They provide the energy necessary to reinstate and sustain homeostasis in response to stress, and to launch energy intensive adaptation programs to ensure an organism’s survival and future well-being. By this means, mitochondria are particularly apt to mediate brain programming by early-life stress (ELS) and to serve at the same time as subcellular substrate in the programming process. With a focus on mitochondria’s integrated role in metabolism, steroidogenesis and oxidative stress, we review current findings on altered mitochondrial function in the brain, the placenta and peripheral blood cells following ELS-dependent programming in rodents and recent insights from humans exposed to early life adversity (ELA). Concluding, we propose a role of the mitochondrion as subcellular intersection point connecting ELS, brain programming and mental well-being, and a role as a potential site for therapeutic interventions in individuals exposed to severe ELS.

PLIN2 Is Essential for Trophoblastic Lipid Droplet Accumulation and Cell Survival During Hypoxia

Trophoblast hypoxia and injury, key components of placental dysfunction, are associated with fetal growth restriction and other complications of pregnancy. Accumulation of lipid droplets has been found in hypoxic nonplacental cells. Unique to pregnancy, lipid accumulation in the placenta might perturb lipid transport to the fetus. We tested the hypothesis that hypoxia leads to accumulation of lipid droplets in human trophoblasts and that trophoblastic PLIN proteins play a key role in this process. We found that hypoxia promotes the accumulation of lipid droplets in primary human trophoblasts. A similar accretion of lipid droplets was found in placental villi in vivo from pregnancies complicated by fetal growth restriction. In both situations, these changes were associated with an increased level of cellular triglycerides. Exposure of trophoblasts to hypoxia led to reduced fatty acid efflux and oxidation with no change in fatty acid uptake or synthesis. We further found that hypoxia markedly stimulated PLIN2 mRNA synthesis and protein expression, which colocalized to lipid droplets. Knockdown of PLIN2, but not PLIN3, enhanced trophoblast apoptotic death, and overexpression of PLIN2 promoted cell viability. Collectively, our data indicate that hypoxia enhances trophoblastic lipid retention in the form of lipid droplets and that PLIN2 plays a key role in this process and in trophoblast defense against apoptotic death. These findings also imply that this protective mechanism may lead to diminished trafficking of lipids to the developing fetus.

Mitochondria and Coenzyme Q10 in the Pathogenesis of Preeclampsia

Hypertensive disorders during pregnancy constitute one of the main causes of maternal and perinatal morbidity and mortality across the world and particularly in developing countries such as Ecuador. However, despite its impact on public health, the primary pathophysiological processes involved are yet to be elucidated. It has been proposed, among other theories, that an abnormal placentation may induce an endothelial dysfunction, which is ultimately responsible for the final clinical manifestations. Mitochondria, particularly from trophoblastic cells, are responsible for the production of energy, which is extremely important for normal placentation. The malfunction in this supply of energy may produce higher levels of free radicals. In both production of energy and free radicals, coenzyme Q10 (CoQ10) plays a crucial role in electron transport. As such, the role of CoQ10 in the genesis and prevention of preeclampsia has become the focus of a number of research groups, including that of the authors. Developing an in-depth understanding of these mechanisms might allow us to design new and feasible strategies with which we can reduce preeclampsia, particularly in the Latin-American countries.

Oxidative stress in healthy pregnancy and preeclampsia is linked to chronic inflammation, iron status and vascular function

Background

During normal pregnancy, placental oxidative stress (OS) is present during all three trimesters and is necessary to obtain normal cell function. However, if OS reaches a certain level, pregnancy complications might arise. In preeclampsia (PE), a dangerous pregnancy specific hypertensive disorder, OS induced in the ischemic placenta causes a systemic inflammatory response and activates maternal endothelial cells. In this study, we aimed to quantify superoxide concentrations (as a measure of systemic OS) using electron paramagnetic resonance (EPR) and correlate them to markers of systemic inflammation, iron status and vascular function.

Methods

Fifty-nine women with a healthy pregnancy (HP), 10 non-pregnant controls (NP) and 28 PE patients (32±3.3weeks) were included. During HP, blood samples for superoxide, neutrophil to lymphocyte ratio (NLR), mean platelet volume (MPV) and iron status were taken at 10, 25 and 39 weeks. Vascular measurements for arterial stiffness (carotid-femoral pulse wave velocity (CF-PWV), augmentation index (AIx), augmentation Pressure (AP)) and microvascular endothelial function (reactive hyperemia index (RHI)) were performed at 35 weeks. In PE, all measurements were performed at diagnosis. CMH (1-hydroxy-3-methoxycarbonyl-2,2,5,5-tetramethylpyrrolidine) was used as spin probe for EPR, since the formed CM radical corresponds to the amount of superoxide.

Results

Superoxide concentration remains stable during pregnancy (p = 0.92), but is significantly higher compared to the NP controls (p<0.0001). At 25 weeks, there is a significant positive correlation between superoxide and ferritin concentration. (p = 0.04) In PE, superoxide, systemic inflammation and iron status are much higher compared to HP (all p<0.001). During HP, superoxide concentrations correlate significantly with arterial stiffness (all p<0.04), while in PE superoxide is significantly correlated to microvascular endothelial function (p = 0.03).

Conclusions

During HP there is an increased but stable oxidative environment, which is correlated to ferritin concentration. If superoxide levels increase, there is an augmentation in arterial stiffness. In PE pregnancies, systemic inflammation and superoxide concentrations are higher and result in a deterioration of endothelial function. Together, these findings support the hypothesis that vascular function is directly linked to the amount of OS and that measurement of OS in combination with vascular function tests might be used in the prediction of PE.

Changes in circulating levels of carboxymethyllysine, soluble receptor for advanced glycation end products (sRAGE), and inflammation markers in women during normal pregnancy

Objective: To determine the circulating levels of insulin, Nε-carboxymethyllysine (CML), soluble receptor for advanced glycation end products (sRAGE), and markers of inflammation and oxidative stress (OS) in maternal and umbilical cord blood in a cohort of healthy women with normal pregnancy.Methods: We conducted an observational longitudinal study in a group of women (n = 31; age range 18-39 years) with healthy pregnancy starting at 30 weeks of gestation and finishing at the time of delivery. We collected weight and height in the participants and their neonates and calculated body mass index (BMI). Blood from each patient was collected at 30th week of pregnancy and at delivery when a sample of cord blood was also obtained. Glucose, lipid profile, CML, sRAGE, malondialdehyde (MDA), tumor necrosis factor-α (TNF-α), highly sensitivity C-reactive protein (hsPCR), and insulin were determined. The study was approved by the University of Guanajuato Institutional Ethics Committee.Results: All pregnancies reached term (mean gestational time 38.9 ± 0.83 weeks) and there were no maternal complications. Mean age was 27.6 years. Lipid profile values were higher in the group compared with our values in nonpregnant women. During pregnancy, levels of insulin increased (p < .0006), CML (p < .0001) and sRAGE (p < .01) decreased, levels of MDA did not change, while those of TNF-α and hsPCR tended to increase. In the neonates, we found lower levels of CML (p < .003), hsPCR (p < .004), and insulin (p < .004) and higher levels of sRAGE (p < .013) and TNF-α (p < .022) compared to their mothers at delivery. In the total group, we found association of CML of the mother at baseline with the CML (p < .0006) and MDA (p < .002) in neonates, while maternal sRAGE at the end of pregnancy was associated with CML (p < .004) of their neonates.Conclusions: Our study confirms that normal pregnancy is accompanied by insulin resistance (IR) and significant increase in lipid profile, and demonstrates that circulating levels of CML and sRAGE decreased significantly at the end of pregnancy. The lack of association between the course of insulin levels and those of CML probably results from the predominant role of placental factors in the pathogenesis of IR in pregnancy. sRAGE levels in the neonates are markedly increased compared to their mothers suggesting a placental origin of this compound which may have a protective effect on the fetus since sRAGE restricts Advanced glycation end product (AGE) effects and may exert anti-inflammatory effects.

Saturated and unsaturated fatty acids differentially regulate in vitro and ex vivo placental antioxidant capacity

PROBLEM

Complications from prematurity are the leading cause of death among children under 5 years of age. Although clinical studies have shown a positive correlation between maternal high-fat diet (HFD) and preterm birth (PTB), the underlying mechanisms remain to be elucidated. Furthermore, it remains unclear how fatty acid type influences the effects of bacterial endotoxins.

METHOD OF STUDY

HTR-8/SVneo trophoblasts were cultured in either 0.5 mmol L^-1 palmitic acid (PA) or linoleic acid (LA) in the absence or presence of 100 μg mL^-1 of lipopolysaccharide (LPS) or lipoteichoic acid (LTA). Murine placental explants were cultured in either 2 mmol L^-1 PA or LA, and cell viability, total antioxidant capacity (TAC), lipid peroxidation, H₂ O₂ , heme oxygenase-1 (HO-1), and nuclear erythroid 2-related factor 2 (Nrf-2) and nuclear factor-kappa light-chain enhancer of activated B cells (NF-κB) transcription factor activity assays were assessed.

RESULTS

Palmitic acid significantly (i) increased cell death, (ii) decreased TAC, and (iii) increased lipid peroxidation; but did not significantly increase HO-1. In contrast, LA maintained cell viability and significantly increased TAC and HO-1. In addition, incubating placental explants with PA significantly increased NF-κB activity. Co-incubating cells with PA and LPS or LTA significantly potentiated H₂ O₂ production and increased lipid peroxidation. Co-incubating cells with PA and LTA synergistically impaired TAC, and LTA decreased TAC more so than LPS. Co-incubation with PA/LA and LPS/LTA decreased HO-1 levels compared to treatment with either fatty acid alone.

CONCLUSION

Our findings suggest that saturated and unsaturated fats differentially regulate placental viability, antioxidant capacity, and inflammation and the actions of gram-positive and gram-negative endotoxins.

Higher Level of Oxidative Stress Markers in Small for Gestational Age Newborns Delivered by Cesarean Section at Term

INTRODUCTION

The aim of our study was to determine lipid peroxidation products and antioxidant enzyme activity in umbilical cord blood of small for gestational age (SGA) neonates.

MATERIALS AND METHODS

Umbilical cord arterial blood samples were collected from 21-term singleton SGA newborn infants and 21 age- and sex-matched appropriate for gestational age (AGA) term neonates prospectively born by elective cesarean section for determination of malondialdehyde (MDA) as a marker of lipid peroxidation and superoxide dismutase (SOD) for antioxidant activity.

RESULTS

MDA levels were increased (5.20 vs. 3.52 nmol/mL; p < 0.001), while levels of SOD (6.24 vs. 8.99 U/mL; p < 0.01) were decreased in SGA neonates when compared with AGA newborn infants.

CONCLUSIONS

Elevated MDA levels and decreased SOD activity in umbilical cord blood may show the possibility of insufficient protective mechanisms against increased oxidative stress in SGA neonates born by cesarean section.

Transfer of maternal psychosocial stress to the fetus

Psychosocial maternal stress experienced during different vulnerable periods throughout gestation is thought to increase the individual's risk to develop neuropsychiatric, cardiovascular and metabolic disease in later life. Cortisol has generally been identified as the major mediator of maternal stress transfer to the fetus. Its lipophilic nature allows a trans-placental passage and thus excessive maternal cortisol could persistently impair the development of the fetal hypothalamic-pituitary-adrenal axis (HPAA). However, cortisol alone cannot fully explain all effects of maternal stress especially during early to mid pregnancy before maturation of the fetal HPAA has even begun and expression of fetal glucocorticoid receptors is limited. This review focuses on mediators of maternal fetal stress transfer that in addition to cortisol have been proposed as transmitters of maternal stress: catecholamines, cytokines, serotonin/tryptophan, reactive-oxygen-species and the maternal microbiota. We propose that the effects of psychosocial maternal stress on fetal development and health and disease in later life are not a consequence of a single pathway but are mediated by multiple stress-transfer mechanisms acting together in a synergistic manner.

Oxidative stress in pregnancy and reproduction

Oxidative stress is implicated in the pathophysiology of many reproductive complications including infertility, miscarriage, pre-eclampsia, fetal growth restriction and preterm labour. The presence of excess reactive oxygen species can lead to cellular damage of deoxyribonucleic acids, lipids and proteins. Antioxidants protect cells from peroxidation reactions, limiting cellular damage and helping to maintain cellular membrane integrity. There is overwhelming evidence for oxidative stress causing harm in reproduction. However, there is sparse evidence that supplementation with commonly used antioxidants (mostly vitamins C and E) makes any difference in overcoming oxidative stress or reversing disease processes. There may be potential for antioxidant therapy to ameliorate or prevent disease, but this requires a thorough understanding of the mechanism of action and specificity of currently used antioxidants.

Decreased reactive oxygen species production and NOX1, NOX2, NOX4 expressions contribute to hyporeactivity to phenylephrine in aortas of pregnant SHR

AIMS

We determined whether decreased reactive oxygen species (ROS) production in the aorta of pregnant spontaneously hypertensive rats (SHR) resulted in increased nitric oxide (NO) bioavailability and hyporeactivity to phenylephrine (PE).

MAIN METHODS

Systemic and aortic oxidative stress were measured in pregnant and non-pregnant Wistar rats and SHR. Furthermore, the hypotensive effects of apocynin (30 mg/kg) and Tempol (30 mg/kg) were analyzed. Intact aortic rings of pregnant and non-pregnant rats were stimulated with PE in the absence of or after incubation (30 min) with apocynin (100 μmol/L). The effect of apocynin on the concentrations of NO and ROS were measured in aortic endothelial cells (AEC) using DAF-2DA (10 mmol/L) and DHE (2.5 mmol/L), respectively. Western blotting was performed to analyze eNOS, NOX1, NOX2, NOX4 and SOD expression. ROS production was analyzed by the lucigenin chemiluminescence method.

KEY FINDINGS

Aortic oxidative stress and ROS concentration in AEC were reduced in pregnant Wistar rats and SHR, when compared to non-pregnant rats. ROS production and NOX1, NOX2 and NOX4 expression in the aortas were decreased in pregnant SHR, but not in pregnant Wistar rats. Increased eNOS expression in aortas and NO concentration in AEC were observed in pregnant Wistar rats and SHR. Apocynin reduced PE-induced vasoconstriction in the aortas of non-pregnant Wistar rats and SHR, and pregnant Wistar rats, but not in the aortas of pregnant SHR.

SIGNIFICANCE

Taken together, these results suggest that ROS production was decreased in the aortas of pregnant SHR and could contribute to higher NO bioavailability and hyporeactivity to PE in the aortas of pregnant SHR.

The longitudinal change of extracellular antioxidant status during pregnancy using an electron spin resonance method

OBJECTIVE

To evaluate the longitudinal change of extracellular antioxidant status during pregnancy.

METHODS

A longitudinal study involving 21 cases of pregnant women without medical disorders and had a vaginal birth was undertaken. Blood was obtained at early, mid and late pregnancy, labor onset, and postpartum day 1 and 5. We measured oxygen radical absorbance capacity (ORAC) and superoxide radical-eliminating ability (SREA) in serum using an electron spin resonance method. Twelve healthy volunteers were recruited as controls. Longitudinal and temporal changes were compared.

RESULTS

ORAC increased significantly during the antepartum period (at early, mid and late pregnancy), decreased once during the peripartum period (in labor and day 1), and then recovered at day 5. SREA showed a similar tendency as ORAC. Interestingly, the ORAC of controls (919.7 ± 48.2 µmol TE/L) was significantly higher than those pregnant women at early pregnancy (early pregnancy: 699.2 ± 127.5, p < 0.01) and day 1 (740.3 ± 101.0, p < 0.01). The ORAC of controls was comparable to at late pregnancy and day 5 (1066.4 ± 189.6 and 920.3 ± 106.6, respectively). The SREA of controls (77.8 ± 31.2 arbitrary unit) was high, but there was no significant difference against the study group.

CONCLUSION

Antioxidant ability of serum clearly fluctuated during periods that may be critical, namely, early pregnancy and peripartum period.

Potential Utility of Melatonin in Preeclampsia, Intrauterine Fetal Growth Retardation, and Perinatal Asphyxia

AIM

Reactive oxygen species play an important role in the pathogenesis of several diseases during gestation and the perinatal period. During pregnancy, increased oxygen demand augments the rate of production of free radicals. Oxidative stress is involved in pregnancy disorders including preeclampsia and intrauterine fetal growth retardation (IUGR). Moreover, increased levels of oxidative stress and reduced antioxidative capacities may contribute to the pathogenesis of perinatal asphyxia. Melatonin, an efficient antioxidant agent, diffuses through biological membranes easily and exerts pleiotropic actions on every cell and appears to be essential for successful gestation. This narrative review summarizes current knowledge concerning the role of melatonin in reducing complications during human pregnancy and in the perinatal period.

RESULTS

Melatonin levels are altered in women with abnormally functioning placentae during preeclampsia and IUGR. Short-term melatonin therapy is highly effective and safe in reducing complications during pregnancy and in the perinatal period. Because melatonin has been shown to be safe for both mother and fetus, it could be an attractive therapy in pregnancy and is considered a promising neuroprotective agent in perinatal asphyxia.

CONCLUSION

We believe that the use of melatonin treatment during the late fetal and early neonatal period might result in a wide range of health benefits, improved quality of life, and may help limit complications during the critical periods prior to, and shortly after, delivery.

Placental Oxidative Status throughout Normal Gestation in Women with Uncomplicated Pregnancies

The effects of gestational age on placental oxidative balance throughout gestation were investigated in women with uncomplicated pregnancies. Placental tissues were obtained from normal pregnant women who delivered at term or underwent elective pregnancy termination at 6 to 23 + 6 weeks of pregnancy. Placental tissues were analyzed for total antioxidant capacity (TAC) and lipid peroxide (malondialdehyde, MDA) levels using commercially available kits. Two hundred and one placental tissues were analyzed and the mean ± SD MDA (pmol/mg tissue) and TAC (µmol Trolox equivalent/mg tissue) levels for first, second, and third trimester groups were 277.01 ± 204.66, 202.66 ± 185.05, and 176.97 ± 141.61, P < 0.004 and 498.62 ± 400.74, 454.90 ± 374.44, and 912.19 ± 586.21, P < 0.0001 by ANOVA, respectively. Our data reflects an increased oxidative stress in the placenta in the early phase of normal pregnancy. As pregnancy progressed, placental antioxidant protective mechanisms increased and lipid peroxidation markers decreased resulting in diminution in oxidative stress. Our findings provide a biochemical support to the concept of a hypoxic environment in early pregnancy. A decrease in placental oxidative stress in the second and third trimesters appears to be a physiological phenomenon of normal pregnancy. Deviations from this physiological phenomenon may result in placental-mediated disorders.

Oxidative stress markers in hypertensive states of pregnancy: preterm and term disease

Discussion continues as to whether de novo hypertension in pregnancy with significant proteinuria (pre-eclampsia; PE) and non-proteinuric new hypertension (gestational hypertension; GH) are parts of the same disease spectrum or represent different conditions. Non-pregnant hypertension, pregnancy and PE are all associated with oxidative stress. We have established a 6 weeks postpartum clinic for women who experienced a hypertensive pregnancy. We hypothesized that PE and GH could be distinguished by markers of oxidative stress; thiobarbituric acid reactive substances (TBARS) and antioxidants (ferric ion reducing ability of plasma; FRAP). Since the severity of PE and GH is greater pre-term, we also compared pre-term and term disease. Fifty-eight women had term PE, 23 pre-term PE, 60 had term GH and 6 pre-term GH, 11 pre-existing (essential) hypertension (EH) without PE. Limited data were available from normotensive pregnancies (n = 7) and non-pregnant controls (n = 14). There were no differences in postpartum TBARS or FRAP between hypertensive states; TBARS (P = 0.001) and FRAP (P = 0.009) were lower in plasma of non-pregnant controls compared to recently-pregnant women. Interestingly FRAP was higher in preterm than term GH (P = 0.013). In PE and GH, TBARS correlated with low density lipoprotein (LDL)-cholesterol (P = 0.036); this association strengthened with inclusion of EH (P = 0.011). The 10 year Framingham index for cardiovascular risk was positively associated with TBARS (P = 0.003). Oxidative stress profiles do not differ between hypertensive states but appear to distinguish between recently-pregnant and non-pregnant states. This suggests that pregnancy may alter vascular integrity with changes remaining 6 weeks postpartum. LDL-cholesterol is a known determinant of oxidative stress in cardiovascular disease and we have shown this association to be present in hypertensive pregnancy further emphasizing that such a pregnancy may be revealing a pre-existing cardiovascular risk.

Oxidative stress-mediated aging during the fetal and perinatal periods

Oxidative stress is worldwide recognized as a fundamental component of the aging, a process that begins before birth. There is a critical balance between free radical generation and antioxidant defenses. Oxidative stress is caused by an imbalance between the production of free radicals and the ability of antioxidant system to detoxify them. Oxidative stress can occur early in pregnancy and continue in the postnatal period; this damage is implicated in the pathophysiology of pregnancy-related disorders, including recurrent pregnancy loss, preeclampsia and preterm premature rupture of membranes. Moreover, diseases of the neonatal period such as bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis, and periventricular leukomalacia are related to free radical damage. The specific contribution of oxidative stress to the pathogenesis and progression of these neonatal diseases is only partially understood. This review summarizes what is known about the role of oxidative stress in pregnancy and in the pathogenesis of common disorders of the newborn, as a component of the early aging process.

Maternal plasma levels of interleukin-6, C-reactive protein, vitamins C, E and A, 8-isoprostane and oxidative status in women with preterm premature rupture of membranes

OBJECTIVE

Preterm premature rupture of membranes (PPROM) is associated with significant maternal and perinatal morbidity. This study examined maternal oxidative stress in PPROM.

METHODS

This was a prospective cross-sectional study conducted in a university hospital. A total of 72 pregnant women were recruited into two groups, those with PPROM (38 cases) and those without PPROM (34 controls) matched for gestational age. Plasma interleukin-6, C-reactive protein, vitamins C, E and A, 8-isoprostane, total oxidant status (TOS) and antioxidant status (TAS) were determined for all study participants and the data were compared between the PPROM and control groups.

RESULTS

Both case and control groups were comparably matched in age, parity, gestational age and smoking status. There was a significant association between low 8-isoprostane, low vitamin C and high total oxidant status and the occurrence of PPROM (p < 0.001).

CONCLUSIONS

Plasma vitamin C and 8-isoprostane levels were lower and TOS higher in women with PPROM. Further research is needed to identify robust biological markers for the prevention and also prognosis of PPROM.

Effects of sevoflurane and desflurane on oxidative stress during general anesthesia for elective cesarean section

BACKGROUND

Anesthetic agents might considerably influence maternal-fetal oxidative stress and antioxidants during cesarean section (CS). The aim of this study was to investigate the effects of desflurane and sevoflurane on oxidative stress parameters both in mothers and newborns undergoing elective CS.

MATERIALS AND METHODS

Eighty ASA physical status I-II, term parturients undergoing elective CS under general anesthesia were randomized to desflurane (Group D) and sevoflurane (Group S) groups. Blood samples were collected from mothers before operation and postoperatively and umbilical artery samples were obtained at delivery. Total oxidant status (TOS), total antioxidant capacity (TAC) status, lipid hydroperoxide (LOOH), and free sulfhydryl (-SH) levels were measured and oxidative stress index was calculated. Secondary outcomes included maternal hemodynamics.

RESULTS

Preoperative LOOH, TOS, OSI, TAC, and -SH levels were similar among groups. Postoperative maternal serum LOOH, TOS, and OSI levels were significantly increased in Group D compared to Group S (p = 0.003, p = 0.005, p = 0.04; respectively). Postoperative umbilical artery LOOH, TOS, OSI levels were also significantly increased in Group D compared to Group S (p = 0.04, p = 0.02, p = 0.01; respectively). Postoperative TOS (p = 0.001, < 0.001 respectively) and OSI (p = 0.003, < 0.001 respectively) levels in both Group D and Group S were statistically significantly decreased compared to preoperative levels. Postoperative LOOH and -SH levels in Group S (p = 0.04, 0.029 respectively) were statistically significantly decreased compared to preoperative levels. There were no significant differences in TAC and -SH levels among groups (p = nonsignificant [n.s.]). Maternal perioperative mean blood pressure and heart rate were similar among groups (p = n.s.).

CONCLUSION

Oxidative stress indices might be modified with preferred anesthetic agent and sevoflurane showed more favorable effects than desflurane in view of oxidative stress.

Teduglutide, a glucagon-like peptide 2 analogue: a novel protective agent with anti-apoptotic and anti-oxidant properties in mice with lung injury

Teduglutide is a long-acting synthetic analogue of human glucagon-like peptide-2 (GLP-2). GLP-2 regulates cell proliferation and apoptosis as well as normal physiology in the gastrointestinal tract. In the present study, possible cytoprotective and reparative effects of teduglutide were analyzed on a mouse model with lung injury induced by tumor necrosis factor-alpha (TNF-α) and actinomycin D (Act D). BALB/c mice were divided into six groups: control mice (I), mice injected intraperitoneally with 15 μg/kg TNF-α (II), 800 μg/kg Act D (III), Act D 2 min prior to TNF-α administration with the same doses (IV), mice injected subcutaneously with 200 μg/kg teduglutide every 12h for 10 consecutive days (V), and mice given Act D 2 min prior to TNF-α administration on day 11 after receiving teduglutide for 10 days (VI). The TNF-α/Act D administration made the lung a sensitive organ to damage. Mice lung subjected to TNF-α/Act D were characterized by the disruption of alveolar wall, induced pulmonary endothelial/epithelial cell apoptosis and expression of active caspase-3. These mice exhibited an increase in lipid peroxidation, glutathione levels, and activities of myeloperoxidase, superoxide dismutase, catalase, glutathione peroxidase and xanthine oxidase, as well as reduced tissue factor and sodium-potassium/ATPase activities. Teduglutide pretreatment regressed the structural damage, cell apoptosis and oxidative stress by reducing lipid peroxidation in mice received TNF-α/Act D. GLP-2 receptors were present on the cell membrane of type II pneumocytes and interstitial cells. Thus, teduglutide can be suggested as a novel protective agent, which possesses anti-apoptotic and anti-oxidant properties, against lung injury.

The effects of oxidative stress on female reproduction: a review

Oxidative stress (OS), a state characterized by an imbalance between pro-oxidant molecules including reactive oxygen and nitrogen species, and antioxidant defenses, has been identified to play a key role in the pathogenesis of subfertility in both males and females. The adverse effects of OS on sperm quality and functions have been well documented. In females, on the other hand, the impact of OS on oocytes and reproductive functions remains unclear. This imbalance between pro-oxidants and antioxidants can lead to a number of reproductive diseases such as endometriosis, polycystic ovary syndrome (PCOS), and unexplained infertility. Pregnancy complications such as spontaneous abortion, recurrent pregnancy loss, and preeclampsia, can also develop in response to OS. Studies have shown that extremes of body weight and lifestyle factors such as cigarette smoking, alcohol use, and recreational drug use can promote excess free radical production, which could affect fertility. Exposures to environmental pollutants are of increasing concern, as they too have been found to trigger oxidative states, possibly contributing to female infertility. This article will review the currently available literature on the roles of reactive species and OS in both normal and abnormal reproductive physiological processes. Antioxidant supplementation may be effective in controlling the production of ROS and continues to be explored as a potential strategy to overcome reproductive disorders associated with infertility. However, investigations conducted to date have been through animal or in vitro studies, which have produced largely conflicting results. The impact of OS on assisted reproductive techniques (ART) will be addressed, in addition to the possible benefits of antioxidant supplementation of ART culture media to increase the likelihood for ART success. Future randomized controlled clinical trials on humans are necessary to elucidate the precise mechanisms through which OS affects female reproductive abilities, and will facilitate further explorations of the possible benefits of antioxidants to treat infertility.

Relationship between 8-hydroxydeoxyguanosine levels in placental/umbilical cord blood and maternal/neonatal obstetric factors

Oxidative stress is associated with the development of various diseases including cancer, arteriosclerosis, diabetes mellitus, hypertension and metabolic syndrome. However, little is known about the involvement of 8-hydroxydeoxyguanosine (8-OHdG) during the perinatal period. At present, few studies have investigated the precise correlations between 8-OHdG levels in cord blood (CB) and the physical conditions of the mother and neonate. To clarify the involvement of 8-OHdG during the perinatal period, the relationships between CB 8-OHdG levels and maternal/neonatal characteristics in vaginal deliveries were determined. The 8-OHdG levels of CB units collected from singleton gestation vaginal deliveries were analyzed. The relationships between 8-OHdG levels and perinatal characteristics were analyzed. The 8-OHdG levels in CB ranged from 0.1 to 1.39 ng/ml (median, 0.37 ng/ml). The relationships between 8-OHdG levels and the perinatal data were analyzed. The 8-OHdG levels detected in the non-smoking group were significantly lower compared to those in the smoking group. However, no significant correlation was observed between 8-OHdG levels and other maternal/ neonatal factors, including umbilical artery acid/base and gas values. Maternal smoking increases the level of the oxidative DNA damage biomarker 8-OHdG in CB. Since oxidative stress may influence the long-term health outcomes of infants after birth, understanding maternal and fetus/neonate stress conditions at delivery may help improve the health of fetuses and infants.

Oxidative stress and antioxidant defenses in pregnant women

OBJECTIVES

Oxidative stress (OS) is defined as an imbalance in the production of reactive oxygen species and the capacity of antioxidant defenses. The objective of this work was to investigate OS and antioxidant capacity in pregnant women.

METHODS

Parameters of the oxidative status and antioxidant capacity in serum and whole blood were evaluated in thirty-nine women with normal pregnancy.

RESULTS

The assessment of antioxidants indicated an increase in superoxide dismutase and catalase activities (P<0.05 and P<0.01) and a decrease in ascorbic acid levels and the total content of sulfhydryl (P<0.05 and P<0.001). Additionally, when the pro-oxidant system was investigated we found an increase (P<0.01) in malondialdehyde and no significant change (P>0.05) in protein carbonylation.

DISCUSSION

This study demonstrates that there is a change in the pro-oxidant and antioxidant defenses associated with body and circulation changes that are inherent to the pregnancy process.

Oxidative stress in chronic otitis media with effusion

CONCLUSIONS

The high oxidant levels in chronic otitis media with effusion (OME) observed in our research and the improvement seen in children with chronic OME after antioxidant treatment suggest that oxygen-derived free radicals play an important role in chronic OME.

OBJECTIVES

OME is a common pathologic condition characterized by nonpurulent fluid in the middle ear (ME) that leads to moderate conductive hearing loss and flat tympanogram. During OME inflammatory cells generate large amounts of superoxide radicals to improve bactericidal activity. Overproduction of oxygen-derived free radicals induces oxidative damage in humans. Glutathione (GSH) is one of the major components of the antioxidant system that protects cells from oxidative stress. The aim of the study was to evaluate oxidative stress in chronic OME by investigation of ME fluids collected during myringotomy.

METHODS

During myringotomy, fluid was collected from the ME to evaluate lipid peroxide levels in the effusion. Fifty-nine children with ME effusion without any resolution after repeated medical treatments were enrolled in the study.

RESULTS

Lipid peroxide levels in all samples were high (mean 11.5 nmole/million cells), similar to the values found in other chronic diseases. GSH might be employed during surgery while applying ventilation tubes and after surgery to prevent oxidative stress.

The association between maternal oxidative stress at mid-gestation and subsequent pregnancy complications

OBJECTIVE

To investigate the association between maternal oxidative stress at mid-gestation and subsequent development of pregnancy complications.

STUDY DESIGN

A total of 503 healthy pregnant women provided their blood and urine samples at 24 to 26 weeks of gestation and were prospectively followed through postpartum. These samples were used to assess a variety of oxidative stress markers, including plasma total antioxidant capacity, 8-isoprostane, erythrocyte glutathione peroxidase and superoxide dismutase activity, and urinary 8-hydroxydeoxyguanosine (8-OHdG).

RESULTS

Compared with women with uncomplicated pregnancies, significantly higher plasma 8-isoprostane levels were noted in women who developed preeclampsia (P = .008) and small-for-gestational age infants (P = .002), while higher urinary 8-OHdG concentrations were noted in women who subsequently had low-birth-weight neonates (<2500 g, P = .043).

CONCLUSION

Increased maternal oxidative stress at mid-gestation was associated with subsequent pregnancy complications.

Quantitation of malondialdehyde in gingival crevicular fluid by a high-performance liquid chromatography-based method

Lipid peroxidation (LPO) has been associated with periodontal disease, and the evaluation of malondialdehyde (MDA) in the gingival crevicular fluid (GCF), an inflammatory exudate from the surrounding tissue of the periodontium, may be useful to clarify the role of LPO in the pathogenesis of periodontal disease. We describe the validation of a method to measure MDA in the GCF using high-performance liquid chromatography. MDA calibration curves were prepared with phosphate-buffered solution spiked with increasing known concentrations of MDA. Healthy and diseased GCF samples were collected from the same patient to avoid interindividual variability. MDA response was linear in the range measured, and excellent agreement was observed between added and detected concentrations of MDA. Samples' intra- and interday coefficients of variation were below 6.3% and 12.4%, respectively. The limit of quantitation (signal/noise=5) was 0.03 μM. When the validated method was applied to the GCF, excellent agreement was observed in the MDA quantitation from healthy and diseased sites, and diseased sites presented more MDA than healthy sites (P<0.05). In this study, a validated method for MDA quantitation in GCF was established with satisfactory sensitivity, precision, and accuracy.

Antioxidant therapies: a potential role in perinatal medicine

Pregnancies complicated by impaired placentation, acute severe reductions in oxygen supply to the fetus, or intrauterine infection are associated with oxidative stress to the mother and developing baby. Such oxidative stress is characterized as an upregulation in the production of oxidative or nitrative free radicals and a concomitant decrease in the availability of antioxidant species, thereby creating a state of fetoplacental oxidative imbalance. Recently, there has been a good deal of interest in the potential for the use of antioxidant therapies in the perinatal period to protect the fetus, particularly the developing brain, against oxidative stress in complications of pregnancy and birth. This review will examine why the immature brain is particularly susceptible to oxidative imbalance and will provide discussion on antioxidant treatments currently receiving attention in the adult and perinatal literature - allopurinol, melatonin, α-lipoic acid, and vitamins C and E. In addition, we aim to address the interaction between oxidative stress and the fetal inflammatory response, an interaction that may be vital when proposing antioxidant or other neuroprotective strategies.

Association between oxidized LDL and folate during pregnancy

High levels of oxidized low-density lipoprotein (ox-LDL) during pregnancy are a risk factor for preeclampsia. Ox-LDL levels might be affected by folate and total homocysteine (tHcy) levels because of their effects on oxygen free radicals. The relationships between ox-LDL and folate and tHcy during pregnancy, however, remain unclear. The present study investigated whether serum folate levels and plasma tHcy levels were associated with plasma ox-LDL levels in pregnant women. A sample of 137 healthy subjects with singleton pregnancies (age 30.3 ± 4.5 years) was recruited from a prenatal clinic in metropolitan Tokyo between June and October 2008. Their levels of plasma ox-LDL, plasma tHcy, and serum folate were measured, and lifestyle variables were obtained using a questionnaire. Dietary intake was assessed by means of a validated self-administered diet history questionnaire. A negative correlation between plasma ox-LDL levels and serum folate levels was found (r(s) = -.218, p =.011). However, there was no association between plasma ox-LDL levels and plasma tHcy levels (r(s) = .055, p = .525). The mean of the logarithmic ox-LDL levels was significantly lower among the participants taking folic acid-containing supplements regularly than among those who were not, after adjusting for confounding factors (p = .024). Serum folate levels and folic acid supplementation might be associated with plasma ox-LDL levels, independent of tHcy levels. The association observed between ox-LDL and folate can be used as evidence for dietary instruction by prenatal care providers.

Microarray assessment of the influence of the conceptus on gene expression in the mouse uterus during decidualization

During pregnancy in several species including humans and rodents, the endometrium undergoes decidualization. This process of differentiation from endometrial to decidual tissue occurs only after the onset of implantation in mice. It can also be artificially induced causing the formation of deciduomal tissue. The purpose of this study was to compare the gene expression profile of the developing decidua in pregnant mice with the deciduoma formed after artificial induction in an effort to identify conceptus-influenced changes in uterine gene expression during decidualization. We induced decidualization artificially by transferring blastocyst-sized ConA-coated agarose beads into the uterus on day 2.5 of pseudopregnancy. Recently published work has found this model to be more 'physiological' than other methods. Total RNA was isolated from blastocyst and bead-induced 'implantation' sites of the uteri of day 7.5 pregnant (decidua) and pseudopregnant (deciduoma) mice respectively. This RNA was then used for microarray analysis using Mouse Illumina BeadArray chips. This analysis revealed potential differential mRNA levels of only 45 genes between the decidua and bead-induced deciduoma tissues. We confirmed the differential mRNA levels of 31 of these genes using quantitative RT-PCR. Finally, the level and localization of some of the mRNAs for select genes (Aldh3a1, Bcmo1, Guca2b, and Inhbb) identified by our microarray analysis were examined in more detail. This study provides the identity of a small set of genes whose expression in the uterus during decidualization may be influenced by molecular signals from the conceptus.

Oxidative stress and eNOS (Glu298Asp) gene polymorphism in preeclampsia in Indian population

Oxidative stress causing widespread endothelial dysfunction has been proposed as a key factor involved in the development of preeclampsia (PE). With this background our objective was to study oxidative stress biomarkers like nitric oxide and malondialdehyde (MDA) and to correlate these markers with endothelial nitric oxide synthase (eNOS) (Glu298Asp) gene polymorphism. This cross-sectional study included 300 pregnant women diagnosed with PE and 200 women with normal pregnancy. Plasma NO and MDA levels were analyzed using student's t test and eNOS gene polymorphism was studied by performing polymerase chain reaction amplification and restriction length polymorphism and frequencies were distributed by using χ(2) analysis. The mean plasma levels of NO were significantly lower in study group while MDA levels were significantly higher in study group (P < 0.001). Genotypic and allelic frequency of eNOS gene in both groups was found to be significant (P < 0.05). The intergenotypic variation of NO and MDA levels was found to be significant (P < 0.001). We concluded that the plasma levels of NO are decreased while MDA levels are increased in subjects with PE and that might contribute to the pathophysiology of PE. As observed in this study Glu298Asp eNOS gene polymorphism showed significant association with PE.

Activation of the receptor for advanced glycation end products system in women with severe preeclampsia

CONTEXT

Activation of the receptor for advanced glycation end products (RAGE) mediates cellular injury. Soluble forms of RAGE [soluble RAGE (sRAGE), endogenous secretory (esRAGE)] bind RAGE ligands, thereby preventing downstream signaling and damage.

OBJECTIVES

The objective of the study was to characterize the changes in maternal serum, amniotic fluid, and cord blood soluble receptor for advanced glycation end products (sRAGE) during physiological gestation and to provide insight into mechanisms responsible for RAGE activation in preeclampsia.

DESIGN AND SETTINGS

This was a cross-sectional study at a tertiary university hospital.

PATIENTS

We studied 135 women in the following groups: nonpregnant controls (n = 16), healthy pregnant controls (n = 68), pregnant women with chronic hypertension (n = 13), or pregnant women with severe preeclampsia (sPE; n = 38).

INTERVENTIONS AND MAIN OUTCOME MEASURES

sRAGE and esRAGE levels were evaluated in vivo by ELISA in maternal serum, amniotic fluid, and cord blood and in vitro after stimulation of the amniochorion and placental explants with lipopolysaccharide or xanthine/xanthine oxidase. Placenta and amniochorion were immunostained for RAGE. Real-time quantitative PCR measured RAGE mRNA.

RESULTS

Pregnant women had significantly decreased serum sRAGE compared with nonpregnant subjects (P < 0.001). sPE women had higher serum and amniotic fluid sRAGE and esRAGE relative to those expected for gestational age (P < 0.001). Cord blood sRAGE remained unaffected by sPE. RAGE immunoreactivity and mRNA expression appeared elevated in the amniochorion of sPE women. Xanthine/xanthine oxidase (but not lipopolysaccharide) significantly up-regulated the release of sRAGE (P < 0.001) in the amniochorion explant system.

CONCLUSIONS

Fetal membranes are a rich source of sRAGE. Elevated maternal serum and amniotic fluid sRAGE and esRAGE, paralleled by increased RAGE expression in the amniochorion, suggest activation of this system in sPE.

Malondialdehyde levels in dental follicles of asymptomatic impacted third molars

PURPOSE

Increased levels of reactive oxygen species lead to oxidative stress and tissue damage. Malondialdehyde (MDA) is one of many low-molecular-weight endproducts of lipid peroxidation that increases with oxidative stress. The aim of this study was to determine oxidative stress in dental follicles (DFs) of radiologically asymptomatic impacted third molars (ITMs) using MDA.

MATERIALS AND METHODS

This study involved 40 DFs of 40 patients referred for clinically and radiographically asymptomatic ITMs. Forty healthy gingival tissues in the same patients were obtained during surgical removal of teeth as a control group. DF widths on periapical radiographs narrower than 2.5 mm were included in the study. All tissues samples were analyzed for MDA as an indicator of oxidative stress.

RESULTS

Levels of MDA were significantly higher in DFs from ITMs than those from healthy gingival tissues of the same patients (P < .01).

CONCLUSION

The results suggest that significant oxidative stress may occur in DFs of asymptomatic ITMs. The findings suggest that increased MDA may play an important role in oxidative stress in DFs. In light of these preliminary findings of the present study, further investigations and comprehensive studies are required to determine the role of antioxidants that scavenge free radicals in DFs.

Prooxidant-antioxidant balance in pregnancy: a randomized double-blind placebo-controlled trial of selenium supplementation

OBJECTIVE

We assessed the impact of selenium, a trace element with antioxidant properties on a simple measure of oxidative stress in pregnant women.

STUDY DESIGN

A novel assay of prooxidant-antioxidant balance (PAB) was applied in a double-blind, placebo-controlled study of selenium supplementation in pregnancy. We measured the prooxidant burden and the antioxidant capacity simultaneously in one assay, thereby calculating a redox index. A total of 166 primigravid pregnant women in the first trimester of pregnancy, were randomized to receive 100 microg of selenium (n=83) or placebo (n=83) per day until delivery. PAB values and serum selenium concentrations were measured at baseline and at the end of study.

RESULTS

Pretreatment demographic data and biochemical indices including serum selenium concentrations did not differ significantly between the groups. The drop-out rates for the groups were 22/83 and 19/83 for the selenium and placebo groups, respectively. Supplementation with selenium was associated with a significant increase in mean serum selenium concentration (P<0.001) but without significant change in mean PAB value. In contrast, mean serum selenium concentration remained unchanged and mean PAB values increased significantly (P<0.05 in the control group).

CONCLUSION

Our findings suggest that selenium supplementation may reduce oxidative stress associated with pregnancy.

Positive correlation between maternal serum coenzyme Q10 levels and infant birth weight

The purpose of this study was to examine the relationship between the level of maternal serum coenzyme Q10 (CoQ10), which is a lipid-soluble antioxidant, maternal body weight gain, fat mass gain, and infant birth weight. A longitudinal observational study was conducted with 50 healthy pregnant women (average age: 31.1 years, average body mass index (BMI): 21.3 kg/m(2) at prepregnancy) at each trimester. CoQ10 levels were measured by high performance liquid chromatography. Maternal weight and body composition were measured by a bioelectrical impedance analysis. The CoQ10 levels significantly increased throughout pregnancy from the first trimester to the third trimester (P < 0.001), and correlated with not only the serum cholesterol levels (P < 0.01) but also with the serum acetoacetic acid levels (P < 0.05) in the third trimester. The CoQ10 levels correlated with the maternal weight gain (P < 0.05) and fat mass gain (P < 0.05) from the second to the third trimester, after adjusting for lipid markers, age, and smoking habits. The level of CoQ10 during the third trimester was also significantly associated with the infant birth weight (P < 0.05) after adjusting for gestational age, maternal prepregnancy BMI, and smoking habits. Therefore, it is concluded that the level of maternal CoQ10 is positively associated with fetal growth, balancing rapid metabolic changes in the last half of a normal pregnancy.

High-saturated-fat diet induces gestational diabetes and placental vasculopathy in C57BL/6 mice

Gestational diabetes mellitus (GDM) is a commonly encountered disorder of mid to late pregnancy that is characterized by hyperglycemia, hyperinsulinemia, and impaired glucose tolerance. Gestational diabetes mellitus is thought to be multifactorial in origin and derives from both genetic and environmental factors. However, the mechanisms underlying GDM are incompletely understood; and current GDM animal models do not appear to closely mimic the clinical situation in humans. The present study used environmental exposure to high-saturated-fat diet (HFD) in an effort to develop a GDM mouse model that closely simulates metabolic abnormalities seen in human GDM. This model was then used to determine the contributions of HFD-induced placental oxidative stress (OS) and vascular dysregulation, which are observed in GDM patients and are believed to contribute to the pathogenesis of the disease. Pathologic manifestations of the disease were quantified by evaluating the extent of placental lipid peroxidation and by determining protective effects of dietary antioxidant quercetin supplementation to reduce HFD-associated placental OS. In this study, female C57BL/6 mice were fed HFD for 1 month before conception and throughout gestation to mimic chronic maternal fast food consumption. Maternal body weight increased from gestation day (GD) 0 to GD19 by 41% with HFD, as compared with 23% in control dams; HFD dams also developed insulin resistance (66% increase in plasma insulin and 27% increase in plasma glucose levels by GD10) as compared with control dams. Placentas from HFD GD19 dams demonstrated loss of trophoblasts and OS-mediated labyrinthine endothelial cellular damage, the latter of which was prevented with quercetin supplementation. Our findings suggest that prenatal HFD alters glucose metabolism and elevates placental OS, which are believed to collectively relate to improper formation of the conceptus and impaired birth outcome.

Selenium supplementation and premature (pre-labour) rupture of membranes: a randomised double-blind placebo-controlled trial

The aim was to determine if selenium supplementation during pregnancy reduces the occurrence of premature (pre-labour) rupture of membranes (PROM). A total of 166 primigravid pregnant women in the first trimester of pregnancy, were randomised to receive 100 microg of selenium (n = 83, drop-outs = 22) or a placebo (n = 83, drop-outs = 19) per day until delivery. The incidence of PROM, as well as serum selenium concentrations were evaluated at baseline and at the end of the study. Supplementation with selenium was associated with a significant increase in mean serum selenium concentration at term (p < 0.001). In contrast, mean serum selenium concentration remained unchanged in the control group (p > 0.05). The incidence of PROM was significantly lower in the selenium group (n = 8, 13.1%) than in the control group (n = 22, 34.4%) (p < 0.01). Our findings indicate that selenium supplementation (100 microg/day) in pregnant women effectively reduces the incidence of PROM.