AUTHOR=Kurlak Lesia O. , Green Amanda , Loughna Pamela , Broughton Pipkin Fiona 

TITLE=Oxidative stress markers in hypertensive states of pregnancy: preterm and term disease

JOURNAL=Frontiers in Physiology

VOLUME=5

YEAR=2014

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2014.00310

DOI=10.3389/fphys.2014.00310

ISSN=1664-042X

ABSTRACT=<p>Discussion continues as to whether <italic>de novo</italic> hypertension in pregnancy with significant proteinuria (pre-eclampsia; PE) and non-proteinuric new hypertension (gestational hypertension; GH) are parts of the same disease spectrum or represent different conditions. Non-pregnant hypertension, pregnancy and PE are all associated with oxidative stress. We have established a 6 weeks postpartum clinic for women who experienced a hypertensive pregnancy. We hypothesized that PE and GH could be distinguished by markers of oxidative stress; thiobarbituric acid reactive substances (TBARS) and antioxidants (ferric ion reducing ability of plasma; FRAP). Since the severity of PE and GH is greater pre-term, we also compared pre-term and term disease. Fifty-eight women had term PE, 23 pre-term PE, 60 had term GH and 6 pre-term GH, 11 pre-existing (essential) hypertension (EH) without PE. Limited data were available from normotensive pregnancies (<italic>n</italic> = 7) and non-pregnant controls (<italic>n</italic> = 14). There were no differences in postpartum TBARS or FRAP between hypertensive states; TBARS (<italic>P</italic> = 0.001) and FRAP (<italic>P</italic> = 0.009) were lower in plasma of non-pregnant controls compared to recently-pregnant women. Interestingly FRAP was higher in preterm than term GH (<italic>P</italic> = 0.013). In PE and GH, TBARS correlated with low density lipoprotein (LDL)-cholesterol (<italic>P</italic> = 0.036); this association strengthened with inclusion of EH (<italic>P</italic> = 0.011). The 10 year Framingham index for cardiovascular risk was positively associated with TBARS (<italic>P</italic> = 0.003). Oxidative stress profiles do not differ between hypertensive states but appear to distinguish between recently-pregnant and non-pregnant states. This suggests that pregnancy may alter vascular integrity with changes remaining 6 weeks postpartum. LDL-cholesterol is a known determinant of oxidative stress in cardiovascular disease and we have shown this association to be present in hypertensive pregnancy further emphasizing that such a pregnancy may be revealing a pre-existing cardiovascular risk.</p>