Abstract
Purpose: To determine whether high-dose intravenous vitamin C reduces oxidative stress in patients with severe preeclampsia in the first days postpartum. Methods: Biomarkers of oxidative stress were assessed as secondary outcomes of a single-center, randomized, placebo-controlled trial. Thirty-four patients with singleton pregnancies complicated by severe features of preeclampsia were randomized into two groups: intravenous vitamin C (1.5 g/6 h) (n = 17) or placebo (n = 17). Urinary concentrations of dityrosine, 8-hydroxy-2-deoxyguanosine (8-OHdg), 8-isoprostane, and N epsilon-(hexanoyl) lysine (HEL) were measured at days one and three after delivery and normalized for urinary creatinine in 22 of patients included (12 in vitamin C and 10 in placebo group). The Mann–Whitney U-test was used to compare values of oxidative stress biomarkers at days one and three after delivery in vitamin C vs. placebo groups (p ≤ 0.05 significant). Results: Dityrosine and 8-OHdg values did not differ significantly between the two study groups at day one after delivery (p = 0.23 and p = 0.77, respectively), but were significantly lower in the vitamin C group compared to the placebo group at day three after delivery (p = 0.04 and p = 0.03, respectively). Values of 8-isoprostane and HEL did not differ significantly between the two study groups at day one (p = 0.41 and p = 0.42, respectively), as well as at day three, after delivery (p = 0.25 and p = 0.24, respectively). Conclusion: High-dose intravenous vitamin C treatments in patients with severe preeclampsia reduced urinary levels of dityrosine and 8-OHdg (markers of protein and DNA oxidative damage, respectively) on day three after delivery. Vitamin C treatment had no significant effect on lipid peroxidation biomarkers, i.e., 8-isoprostane and HEL.
Highlights
Preeclampsia, a pregnancy-specific multisystem disorder characterized by new onset hypertension and proteinuria or end-organ dysfunction after 20 weeks of gestation, affects 2% to 5% of pregnancies [1,2,3]
The main finding of this study is that high-dose intravenous vitamin C treatment started postpartum in patients with severe preeclampsia reduced urinary levels of dityrosine and 8-OHdg on day three after delivery
Leon-Reyes et al reported increased plasma concentrations of dityrosine in women with preeclampsia compared to healthy pregnant controls [28]
Summary
Preeclampsia, a pregnancy-specific multisystem disorder characterized by new onset hypertension and proteinuria or end-organ dysfunction after 20 weeks of gestation, affects 2% to 5% of pregnancies [1,2,3]. It is associated with a high risk of fetal and neonatal complications, as well as maternal morbidity and mortality [3,4,5]. No studies concerning the effects of vitamin C treatment on oxidative stress in postpartum patients with preeclampsia have been published so far
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