Placental Oxidative Stress in the pathogenesis of Hypertensive Disorders of Pregnancy

Martin Awe Akilla

doi:10.51374/annalsmls.2021.1.2.0041

Abstract

Background: Hypertensive disorders of pregnancy are a major complication of pregnancies and can lead to fetal growth retardation, premature delivery and maternal morbidity and mortality. The study aimed at assessing the potential role of the placenta in the pathogenesis of hypertensive disorders of pregnancy. Methods: This study was a case-control study conducted at the Upper East Regional Hospital, Ghana from September, 2016 to March 2017. Twenty (20) pregnant women with hypertensive disorders of pregnancy (i.e., Pregnancy induced hypertension, preeclampsia and eclampsia) as cases and 30 normotensive pregnancies as controls, were included in the study. The placenta was excised after delivery, homogenized and assayed for malondialdehyde, catalase, total peroxide, oxidative stress index, total antioxidant capacity and placental lipid profile. Results: The ages of the two groups were similar, with malondialdehyde (p = 0.001) and Oxidative Stress Index (p < 0.001) being significantly higher in the hypertensive group compared to the control group whereas Total Antioxidant Capacity (p < 0.001) and Catalase (p = 0.011) were significantly higher in the control group compared to the hypertensive group. The proportion of normal, term and livebirth deliveries were significantly higher among controls compared to the hypertensive disorders of pregnancy group. Among the estimated oxidative stress markers, total antioxidant capacity turned out to be the best predictor of the hypertensive disorders of pregnancy. Conclusion: Our findings suggest oxidative stress in women with hypertensive disorders of pregnancy and that placental oxidative stress could be the driving factor for the pathogenesis and severity of these hypertensive disorders of pregnancy.

Highlights

Hypertensive disorders of pregnancy may be described as hypertension with the presence or absence of proteinuria and edema, with the clinical presentation usually occurring late in pregnancy and resolving after delivery (Sravanthi et al, 2017)
Malondialdehyde (p=0.001) and oxidative stress index (p < 0.001) was significantly higher in the pregnancy induced hypertension (PIH) group compared to the control group whereas total antioxidant capacity (p < 0.001) and Catalase (p=0.01) were significantly higher in the control group compared to the PIH group (Table 2)
Among the PIH subjects, a comparison in the levels of oxidative stress indices was made between those who were diagnosed with preeclampsia and those diagnosed with gestational hypertension

Summary

Introduction

Hypertensive disorders of pregnancy may be described as hypertension with the presence or absence of proteinuria and edema, with the clinical presentation usually occurring late in pregnancy and resolving after delivery (Sravanthi et al, 2017) These usually include pregnancy induced hypertension (PIH), pre-eclampsia and eclampsia, with a general incidence of five to ten per cent of all pregnancies (Mohanty et al, 2006), hypertensive disorders in pregnancy are a major complication of pregnancies and can lead to fetal growth retardation, premature delivery and maternal morbidity and mortality (Saczko et al, 2002b). Pregnancy related morbidity and mortality relies on the severity of the hypertension and there is no known way of preventing its complications (Sravanthi et al, 2017) The impact of these disorders on maternal and foetal outcomes can not be underestimated. Oxidative stress has been given considerable attention in its relationship with pregnancy and its complications (Sheena, 2012)

Results

Discussion

Conclusion