Abstract

Increased oxidative/nitrative stress is characteristic not only in pathologic, but also in healthy pregnancy. High uterine artery pulsatility index (UtAPI) at the end of the first trimester is associated with altered placentation and elevated risk for adverse pregnancy outcomes. We aimed to examine the relationship of systemic oxidative/nitrative stress and uterine artery pulsatility index in the first trimester and their correlation to pregnancy outcomes. Healthy pregnant women were recruited at 12-13th gestational week ultrasound examination; UtAPI was determined by color Doppler ultrasound. Patients were divided into high (UtAPI ≥ 2.3) (n = 30) and low (n = 31) resistance groups, and pregnancies were followed until labor. Systemic oxidative/nitrative stress was estimated by measuring total peroxide level, total antioxidant capacity and nitrotyrosine level. Plasma total peroxide level was significantly lower (2,510 ± 39 µM vs. 2,285 ± 59 µM), total antioxidant capacity was higher (781 ± 16 mM CRE vs. 822 ± 13 mM CRE) in the high UtAPI group, which were accompanied by lower birth weight (3,317 ± 64 vs. 3,517 ± 77 g, P < 0.05). Plasma total peroxide level showed a negative correlation (by Pearson) to UtAPI (P < 0.01) and positive correlation to birth weight (P < 0.05). According to our results, lower systemic oxidative stress showed correlation with high UtAPI measured between the 12-13th weeks of gestation. We also found significant differences in the birth weight of healthy newborns; therefore it is worth examining this relationship in pathological pregnancies.

Highlights

  • Increased oxidative/nitrative stress is characteristic in pathologic, and in healthy pregnancy

  • Clinical laboratory parameters including plasma creatinine, liver enzymes, hemoglobin, CRP and glucose levels were similar in our study groups; only LDH was significantly lower in women with higher uterine artery pulsatility index (UtAPI) (Table 1)

  • Correlation between uterine artery pulsatility index and pregnancy outcome The rate of Cesarean section was similar in the two groups

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Summary

Introduction

Increased oxidative/nitrative stress is characteristic in pathologic, and in healthy pregnancy. High uterine artery pulsatility index (UtAPI) at the end of the first trimester is associated with altered placentation and elevated risk for adverse pregnancy outcomes. We aimed to examine the relationship of systemic oxidative/nitrative stress and uterine artery pulsatility index in the first trimester and their correlation to pregnancy outcomes. The decrease in uterine artery pulsatility index (UtAPI) on the border of the first and second trimester is a well-established clinical marker of physiological placentation. This decline is due to the development of the specialized uteroplacental vasculature: expanded, high-flow, low-resistance vessels to satisfy the growing nutritional and oxygen requirements of the fetus [1]. The simultaneous measurement of other early markers, like maternal plasma pregnancy related plasma protein A (PAPP-A), placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), etc. may increase the sensitivity and specificity of the prognosis [6,7,8]

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