Abstract
Introduction It is speculated that preeclampsia and hypertension during pregnancy are associated with an imbalance of the placental antioxidant defence, which results in the overproduction of reactive oxygen species and fetal growth restriction. Many research implied that oxidant stress in utero may be an important determinant of mortality and morbidity in neonates. Moreover, the authors demonstrated the reduced number of nephrons and a higher prevalence of renal injury in neonates with growth restriction, including small for gestational age (SGA) neonates. Alas, it remains unclear whether basal antioxidant status is altered in the kidneys of SGA newborns. Materials and Methods In this study, we assessed neutrophil gelatinase-associated lipocalin (NGAL) and malondialdehyde (MDA) levels in samples collected from umbilical blood and 12 hours after delivery in neonates born by mothers suffering from preeclampsia or hypertension during pregnancy and those from physiological pregnancies. Additionally, the authors evaluated levels of the aforementioned biomarkers regarding the occurrence of growth restriction in newborns. For this study, we enrolled 27 newborns, which fulfilled inclusion criteria for SGA diagnosis (SGA group), while 21 were appropriate for gestational age neonates, as the AGA group. Results In the presented study, we have found significant differences in umbilical cord MDA and NGAL concentration between the SGA and AGA groups. Such dependencies were not found in blood samples from neonates collected in the first 12 hours of life for MDA and NGAL concentrations. Additionally, we have observed differences in umbilical MDA and NGAL levels between newborns of preeclamptic or hypertensive mothers compared to healthy ones. A significant correlation between the occurrence of hypertension during pregnancy and umbilical MDA and NGAL concentrations was also found. Conclusions Small for gestational age newborns or those born by preeclamptic and hypertensive mothers had significantly higher MDA and NGAL levels as compared to healthy ones. Further investigation is needed to understand the pathophysiologic influence of hypertension in pregnancy and oxidative stress injury in newborns with growth restriction.
Highlights
It is speculated that preeclampsia and hypertension during pregnancy are associated with an imbalance of the placental antioxidant defence, which results in the overproduction of reactive oxygen species and fetal growth restriction
Significant differences were found in umbilical cord MDA concentration between the small for gestational age (SGA) and AGA groups (8501.5 [3540.2-10079.5] vs. 3551.4 [2945.08675.8] ng/mL; p = 0:04)
Such dependencies were not found in blood samples from neonates collected in the first 12 hours of life for MDA levels (p = 0:15) as well as neutrophil gelatinaseassociated lipocalin (NGAL) concentrations (p = 0:07)
Summary
It is speculated that preeclampsia and hypertension during pregnancy are associated with an imbalance of the placental antioxidant defence, which results in the overproduction of reactive oxygen species and fetal growth restriction. The authors demonstrated the reduced number of nephrons and a higher prevalence of renal injury in neonates with growth restriction, including small for gestational age (SGA) neonates. Small for gestational age newborns or those born by preeclamptic and hypertensive mothers had significantly higher MDA and NGAL levels as compared to healthy ones. Oxidative stress may be defined as inadequate redox homeostasis, resulting from an intensified generation of reactive oxygen species (ROS) Certain gestational complications, such as hypertension or preeclampsia, seem to be associated with increased exposition to oxidative stress during and after delivery [1,2,3]. It is speculated that increased ROS generation has been implicated in intrauterine perturbations, like placental insufficiency, and may result in intrauterine growth restriction, observed in small for gestational age newborns (SGA) [4]. According to the current literature, hypertension and preeclampsia are described as one of the most common diseases of the gestation period and may affect even 10% of pregnancies worldwide; there is a dire need of finding biomarkers that would help define them in the early clinical stage.
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