47. Oxidative stress in fetal growth restriction with and without pre-eclampsia

Abstract

Introduction Placental insufficiency, due to impaired spiral artery remodeling, is a feature of fetal growth restriction (FGR) and pre-eclampsia. Both conditions occur isolated, nevertheless, preterm FGR frequently occurs in combination with pre-eclampsia. Placental insufficiency is often related to oxidative stress. Locally and systemically produced reactive oxygen species can oxidize plasma free thiols. Thus, decreased free thiol levels indicate increased systemic oxidative stress. Objective/Hypothesis Hence, we expect that plasma free thiol levels are decreased in women with a pregnancy complicated by isolated FGR and pre-eclampsia with FGR as clinical reflection of placental insufficiency and oxidative stress. Methods Women with a singleton pregnancy between 24 and 36 weeks of gestation were included in 2017. A total of twenty-four patients could be included in this pilot study. Patients were assigned to one of the following groups based on pregnancy complications, sequential fetal biometry and Dopplers: isolated FGR(n = 9), FGR with pre-eclampsia(n = 11) or uncomplicated controls(n = 14). Free thiol levels were measured in blood. Placentas were analyzed for signs of placenta insufficiency, such as accelerated maturation, maternal and fetal vascular malperfusion and fetal hypoxia. Results Plasma free thiol levels were significantly lower in women with a pregnancy complicated by pre-eclampsia with FGR compared to pregnancies complicated with isolated FGR and uncomplicated pregnancies (p Discussion Although placental insufficiency applies to both FGR and preeclampsia, oxidative stress is more extensive in pre-eclampsia related FGR compared to isolated FGR and controls. Our histopathologic data suggest that the pathophysiological mechanism in the placenta of FGR in pre-eclamptic women is different from pregnancies complicated with FGR without pre-eclampsia.