The Role of Oxidative Stress in Hypertensive Disorders of Pregnancy (Preeclampsia, Gestational Hypertension) and Metabolic Disorder of Pregnancy (Gestational Diabetes Mellitus)

Abstract

Purpose of the Review.To highlight the role of oxidative stress in hypertensive disorders of pregnancy (HDP) and metabolic disorders of pregnancy (gestational diabetes mellitus). Recent Findings. In both preeclampsia (PE) and gestational hypertension (GH), oxidative stress leads to inadequate placental perfusion thus resulting in a hypoxic placenta, which generally leads to the activation of maternal systemic inflammatory response. In PE, this causes inflammation in the kidneys and leads to proteinuria. A proteinuria marker known as urinary 8-oxoGuo excretion is expressed in preeclampsia. In GDM, oxidative stress plays a role in the pathogenesis of the disease, as a result of over secretion of insulin during pregnancy. This uncontrolled secretion of insulin results in the production of lipid peroxidation factors that also mask the secretion of antioxidants. Therefore, ROS becomes abundant at cellular level and prevents the cells from transporting glucose to body tissues. Summary. There is a need for more research investigating the role of oxidative stress, especially in obstetrics-related conditions. More studies are required in order to understand the difference between the pathogenesis and pathophysiology of PE versus GH since investigations on the differences in genetic aspects of each condition are lacking. Furthermore, research to improve diagnostic procedures for GDM in pregnancy is needed.

Gestational Diabetes Mellitus and Preeclampsia: Correlation and Influencing Factors

“…Gestational diabetes mellitus (GDM) and preeclampsia (PE) are common complications in pregnancy with similar risk factors, including obesity, advanced age, and multiple pregnancy (1,2). Moreover, in both GDM and PE, the pathophysiological processes involve oxidative stress, pro-inflammatory factor release, vascular endothelial dysfunction (3,4), which all increase the risk of future maternal diabetes and cardiovascular disease (5)(6)(7)(8); thus, a correlation between GDM and PE may exist.…”

Towards Personalized Antioxidant Use in Female Infertility: Need for More Molecular and Clinical Studies

“…Two prospective cohort studies [ 64 , 65 ] and four RCTs [ 66 , 67 , 68 , 69 ] evaluated in vivo effects of melatonin administered from the cycle preceding the IVF attempt. It was shown that melatonin reduced the number of degenerated oocytes [ 64 , 69 ], increased the number of mature oocytes [ 66 , 69 ], and increased fertilization rate [ 65 ] and embryo quality [ 69 ].…”

“…Two prospective cohort studies [ 64 , 65 ] and four RCTs [ 66 , 67 , 68 , 69 ] evaluated in vivo effects of melatonin administered from the cycle preceding the IVF attempt. It was shown that melatonin reduced the number of degenerated oocytes [ 64 , 69 ], increased the number of mature oocytes [ 66 , 69 ], and increased fertilization rate [ 65 ] and embryo quality [ 69 ]. One RCT [ 68 ] failed to detect any significant differences in cumulative pregnancy rate or oocyte and embryo parameters, but the authors recognized that the study was not sufficiently powered.…”

“…Oxidative stress is suspected to be involved in the pathogenesis of hypertensive and metabolic disorders of pregnancy [ 69 ]. A mild level of oxidative stress is a natural response of the maternal organism to pregnancy, owing to the increased metabolic activity in the placental mitochondria, related to a higher metabolic demand of the growing fetus [ 70 ].…”

Cord blood metabolomics reveals gestational metabolic disorder associated with anti-thyroid peroxidase antibodies positivity

“…Metabolic syndrome is one of the representatives of increased complications in pregnant women with euthyroid status [ 11 ]. Metabolic syndrome is resulted from abnormal chemical reactions in the body, which contributes to numerous gestational diseases, including gestational diabetes mellitus [ 12 ], gestational hypertension [ 13 ], gestational hypothyroidism [ 14 ], etc. Metabolic disorder also exerts direct adverse effects to the progress and outcome of pregnancy [ 15 ].…”