Department of Pathology, Maastricht University Medical Centre, Maastricht, The Netherlands,
Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht, The Netherlands.
Gynecol Obstet Invest. 2019;84(6):616-622. doi: 10.1159/000501254. Epub 2019 Jul 29.
BACKGROUND/AIMS: Placental syndromes (PS) refer to pregnancy complications that include gestational hypertension, (pre)eclampsia, HELLP syndrome, and/or placental insufficiency-induced fetal growth restriction. These disorders are characterized by increased oxidative stress. This study aims to test the hypothesis that the abnormal hemodynamic adaptation to pregnancy, typical for early PS pregnancy, is accompanied by abnormal maternal levels of antioxidants relative to those in normal pregnancy.
Before, and at 12, 16, and 20 weeks pregnancy, we measured trolox equivalent antioxidant capacity (TEAC), uric acid (UA), and TEACC (TEAC corrected for UA) in maternal serum of former PS patients, who either developed recurrent PS (rPS; n = 16) or had a normal next pregnancy (non-rPS; n = 23). Concomitantly, we also measured various hemodynamic variables.
rPS differed from non-rPS by higher TEACC levels before pregnancy (178 vs. 152 µM; p = 0.02) and at 20 weeks pregnancy (180 vs. 160 µM; p = 0.04). Only non-rPS responded to pregnancy by significant rises in hemodynamic measures.
These data indicate that rPS pregnancies are preceded by an increase in antioxidant capacity, presumably induced by subclinical vascular injury and low-grade chronic inflammation.
背景/目的：胎盘综合征（PS）是指包括妊娠高血压、子痫前期、HELLP 综合征和/或胎盘功能不全引起的胎儿生长受限等妊娠并发症。这些疾病的特征是氧化应激增加。本研究旨在验证这样一个假设，即在早期 PS 妊娠中，胎盘对妊娠的异常血流动力学适应伴随着母体抗氧化剂水平相对于正常妊娠的异常。
在 PS 前、12 周、16 周和 20 周妊娠时，我们测量了前 PS 患者（rPS，n=16；非 rPS，n=23）血清中的生育酚当量抗氧化能力（TEAC）、尿酸（UA）和 TEAC（UA 校正的 TEAC）。同时，我们还测量了各种血流动力学变量。
rPS 与非 rPS 相比，在妊娠前（178 vs. 152 µM；p=0.02）和 20 周妊娠时（180 vs. 160 µM；p=0.04）的 TEACC 水平更高。只有非 rPS 对妊娠有明显的血流动力学反应。
这些数据表明，rPS 妊娠前可能由于亚临床血管损伤和低度慢性炎症而导致抗氧化能力增加。
