Systemic Oxidative Stress in Severe Early-Onset Fetal Growth Restriction Associates with Concomitant Pre-Eclampsia, Not with Severity of Fetal Growth Restriction
Marjon E. Feenstra,
Martin F. Bourgonje,
Arno R. Bourgonje,
Mirthe H. Schoots,
Jan-Luuk Hillebrands,
Anneke C. Muller Kobold,
Jelmer R. Prins,
Harry van Goor,
Wessel Ganzevoort,
Sanne J. Gordijn
Affiliations
Marjon E. Feenstra
Department of Gynecology and Obstetrics, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
Martin F. Bourgonje
Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
Arno R. Bourgonje
Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
Mirthe H. Schoots
Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
Jan-Luuk Hillebrands
Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
Anneke C. Muller Kobold
Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
Jelmer R. Prins
Department of Gynecology and Obstetrics, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
Harry van Goor
Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
Wessel Ganzevoort
Department of Gynecology and Obstetrics, Amsterdam University Medical Centers, Amsterdam Reproduction and Development Research Institute, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
Sanne J. Gordijn
Department of Gynecology and Obstetrics, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
Background: Placental insufficiency is an important mechanism underlying early-onset fetal growth restriction (eoFGR). Reduced placental function causes impaired metabolic and gaseous exchange. This unfavorable placental environment is among other processes characterized by increased oxidative stress. Systemic free thiols (FT) are known for their reactive oxygen species scavenging capacity, and higher plasma levels of FT are associated with a better outcome in a multitude of ischemic and inflammatory diseases. We aimed to investigate the relationships between systemic FT levels and maternal and perinatal clinical characteristics and outcomes. Study design: In a post hoc analysis of the Dutch Strider study, a cohort of women with eoFGR, we investigated the association between the maternal redox status (FT) levels at study inclusion, placental biomarkers, and maternal and neonatal outcomes in 108 patients. Results: FT were significantly lower in pregnancies complicated with eoFGR with concurrent maternal hypertensive disorders (pregnancy-induced hypertension; ρ = −0.281 p = 0.004, pre-eclampsia; ρ = −0.505 p = 0.000). In addition, lower FT levels were significantly associated with higher systolic (ρ = −0.348 p = 0.001) and diastolic blood pressure (ρ = −0.266 p = 0.014), but not with the severity of eoFGR. FT levels were inversely associated with sFlt (ρ = −0.366, p p = 0.002), which was not found in women without hypertensive disorders (ρ = 0.008, p = 0.958). Conclusions: In women with pregnancies complicated with eoFGR, FT levels reflect the severity of maternal disease related to the underlying placental insufficiency rather than the severity of the placental dysfunction as reflected in eoFGR or perinatal outcomes.
