Garcia-Benavides L, Guzman-Sanchez A, Hernandez-Mora F J, Muro-Gomez A M, Gomez-Martinez M L, Siller-Lopez F R
Physiology, Universidad de Guadalajara, Guadalajara, Mexico.
Obstetrics, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Guadalajara, Mexico.
Pregnancy Hypertens. 2012 Jul;2(3):282-3. doi: 10.1016/j.preghy.2012.04.189. Epub 2012 Jun 13.
Pregnancy-induced hypertension (PIH) is a major cause of maternal and perinatal mortality and morbidity, particularly in under-resourced countries, like Mexico. Studies on PIH have shown increased oxidative stress products such as malondialdehyde and decrease of total antioxidant capacity (TAC). In this research we measured one marker of oxidative stress (OS) the TAC in patients with PIH and we associated it with the development of maternal and/or fetal complications.
Determine whether the plasma level of total antioxidant capacity (as a marker of oxidative stress) influences the development of maternal and/or perinatal complications in patients with PIH.
A observational, analytical, clinical study was conducted in patients with gestational hypertension (GH), mild preeclampsia (MP), severe preeclampsia (SP) and normal pregnancy (NP) > or = 28weeks gestational age. Serum samples were collected and stored at -70°C until use for the determination of total antioxidant capacity. It was associated with the development of maternal and/or perinatal complications.
TAC level in normotensive patients (NP) was mean of 2679 +/- 2014mEq/L while in hypertensive patients (GH, MP, SP) was on mean of 1502 +/-1340mEq/L (p<0.05), in the GH group was 1620 +/-1042mEq/L, in the MP group was 1977 +/-1865mEq/L, in the SP was 819 +/-305meq/L The mean TAC level in the 29 patients who had maternal and/or perinatal complications was 1521mEq/L, while in the 38 patients who showed no maternal and/or perinatal complications the mean was 2355mEq/L (p<0.05). Of the 29 patients who had complications 15 (52%) had greatly diminished TAC levels (less than 1000mEq/L), 9 (31%) had between 1000 and 2500mEq/L and only 5 (17%)>2500mEq/L. 72% (28/39) of PIH group had one or more maternal and/or perinatal complications, while only 1 patient (3.6%) of 28 patients with NP had one or more maternal and/or perinatal complications (p<0.05).
Patients with decreased TAC level had a higher percentage of maternal and/or perinatal complications. Patients with PIH classified as mild preeclampsia, showing reduced TAC level should be in close observation as they have the risk of developing life-threatening complications since management is usually as outpatient.
妊娠高血压综合征(PIH)是孕产妇和围产期发病及死亡的主要原因,在资源匮乏的国家(如墨西哥)尤为如此。关于PIH的研究表明,氧化应激产物如丙二醛增加,总抗氧化能力(TAC)下降。在本研究中,我们测量了PIH患者氧化应激(OS)的一个标志物——TAC,并将其与孕产妇和/或胎儿并发症的发生相关联。
确定总抗氧化能力的血浆水平(作为氧化应激的标志物)是否会影响PIH患者孕产妇和/或围产期并发症的发生。
对孕周≥28周的妊娠高血压(GH)、轻度子痫前期(MP)、重度子痫前期(SP)和正常妊娠(NP)患者进行了一项观察性、分析性临床研究。采集血清样本并储存于-70°C,直至用于测定总抗氧化能力。将其与孕产妇和/或围产期并发症的发生相关联。
血压正常患者(NP)的TAC水平平均为2679±2014mEq/L,而高血压患者(GH、MP、SP)的平均水平为1502±1340mEq/L(p<0.05),GH组为1620±1042mEq/L,MP组为1977±1865mEq/L,SP组为819±305mEq/L。29例发生孕产妇和/或围产期并发症患者的TAC平均水平为1521mEq/L,而38例未发生孕产妇和/或围产期并发症患者的平均水平为2355mEq/L(p<0.05)。在29例有并发症的患者中,15例(52%)的TAC水平大幅降低(低于1000mEq/L),9例(31%)在1000至2500mEq/L之间,只有5例(17%)>2500mEq/L。PIH组72%(28/39)有1种或多种孕产妇和/或围产期并发症,而28例NP患者中只有1例(3.6%)有1种或多种孕产妇和/或围产期并发症(p<0.05)。
TAC水平降低的患者发生孕产妇和/或围产期并发症的百分比更高。分类为轻度子痫前期的PIH患者,TAC水平降低,应密切观察,因为他们有发生危及生命并发症的风险,因为管理通常为门诊治疗。