Assessment of Antioxidant Status and Lipid Peroxidation in Pre-Eclampsia

Main Article Content

Patrick O. Manafa
Charles C. Onyenekwe
Anselem C. Igwe
Nancy A. Mbachu
George O. Chukwuma
Rebecca C. Chukwuanukwu
Vera I. Manafa
Kenneth E. Nwene
Nancy C. Ibeh


Aim: To assess the role of antioxidants and lipid peroxidation in the pathogenesis of pre-eclampsia.

Study Design: This is a case-control study designed to evaluate the levels of malondialdehyde and total antioxidant capacity with glutathione peroxidase and superoxide dismutase activities in pre-eclamptic. One hundred (100) participants were randomly selected to include fifty pre-eclamptic (test), twenty-five (25) healthy pregnant normotensive women (control A) and twenty-five healthy non-pregnant normotensive women (control B).

Place and Duration of Study: This study was carried out at the Holy Rosary Hospital waterside, Onitsha, Anambra state. Nigeria. The study lasted for 13 months.

Methodology: One hundred women (50 pre-eclamptic, 25 pregnant normotensives and 25 non-pregnant normotensives) aged 25-40 years were recruited for this study. Blood samples were collected from the participants for the estimation of total antioxidant capacity (TAC), malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities using spectrophotometric methods. Blood pressures were measured using accosson sphygmomanometer. Data were analysed using analysis of variance and Pearson’s correlation coefficient at p < 0.05.

Results: The TAC was significantly higher in the pregnant normotensives (p< 0.05) compared with the pre-eclamptic and non-pregnant normotensives. There was no significant difference in the MDA in pre-eclamptic compared with pregnant normotensives and non-pregnant normotensives (p>0.05). A significant difference was observed in the SOD and GPx activities in the pregnant normotensive and non-pregnant normotensives compared with pre-eclamptic. A positive correlation was observed between the blood pressures (systolic and diastolic) and the activities of TAC, SOD and GPx in pre-eclamptic. Furthermore, a positive correlation was observed between MDA levels and SBP (r = 0.019) while a negative correlation (r = -0.225) existed between MDA and DBP.

Conclusion: Diminished ability of antioxidants to scavenge free radicals may affect the onset of pre-eclampsia and therefore possible prognostic tool in its management.

Antioxidants, pre-eclampsia, glutathione peroxidase, superoxide dismutase, lipid peroxidation

Article Details

How to Cite
Manafa, P. O., Onyenekwe, C. C., Igwe, A. C., Mbachu, N. A., Chukwuma, G. O., Chukwuanukwu, R. C., Manafa, V. I., Nwene, K. E., & Ibeh, N. C. (2019). Assessment of Antioxidant Status and Lipid Peroxidation in Pre-Eclampsia. Journal of Advances in Medical and Pharmaceutical Sciences, 21(4), 1-9.
Original Research Article


Katar M, Ozugurlu AF, Ozyurt H, Benli I. Evaluation of glutathione peroxidase and superoxide dismutase enzyme polymorphisms in celiac disease patients. Genetics and Molecular Research. 2014;13 (1):1030–1037.

Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet.2015;(365):785-799.

Redman CW, Sargent IL. Latest advances in understanding preeclampsia, Science. 2015;(308):1592-1594.
DOI: 10.1126/science.1111726

Toescu V, Nuttall SL, Martin U, Kendall MJ and Dunne F. Oxidative stress and normal pregnancy, Clin Endocrinology. 2002;57(5): 609-613.

Rusterholz C, Hahn S, Holzgreve W. Role of placentally produced inflammatory and regulatory cytokines in pregnancy and the etiology of preeclampsia, Seminar on Immunopathology. 2007;(29):151-162, 2007. DOI:10.1007/s00281-007-0071-6
[PMID: 17621700]

Challis JR, Lockwood CJ, Myatt L, Norman JE, Strauss JF, Petraglia, F. Inflammation and pregnancy. Reprod Sci. 2009;16(2):206- 15.
DOI: 10.1177/1933719108329095

Serdar Z, Gur E, Colakoethullary M, Develioethlu O, Sarandol E. Lipid and protein oxidation and antioxidant function in women with mild and severe preeclampsia, Archives of Gynecology and Obstetrics. 2013;(68):19-25.
[PMID: 12673470]

Dotsch J, Hogen N, Nyul Z, Hanze J, Knerr I, Kirschbaum M. Increase of endothelial nitric oxide synthase and endothelin-1 mRNA expression in human placenta during gestation, European Journal of Obs Gyn and Rep Biol. 2011;(97):163-167.

World Health Organization. WHO recommendations for prevention & treatment of pre-eclampsia and eclampsia. Implications & actions. Geneva. WHO_RHR_14.17;2014.

Mathers CD, Stein C, Ma Fat D, Rao C, Inoue M, Tomijima N, et al., Global Burden of Disease 2000: Ver 2 methods & results. Geneva, WHO (GPE Discussion Paper No. 50); 2002.

Mbachu I, Udigwe GO, Okafor CI, Umeonunilu OS, Ezeama C, Eleje GU. The prevalence of preeclampia among women attending ante natal clinic at Nnamdi Azikiwe University Teaching Hospital, Nnewi. Nig J. Med. 2013;22(2):117- 122.

Soleymanlou N, Jurisica I, Nevo O, Ietta F, Zhang X, Zamudio S et al. Molecular evidence of placental hypoxia in preeclampsia, Journal of Clinical Endocrinology and Metabolism. 2005;(90): 4299-4308.

Davey MWI, Stals E, Panis B, Keulemans J& Swennen RL. High throughput determination of malondialde hyde in plant tissues. Anal Biochem. 2005;347(2):201–207.

Del Rio D, Stewart AJ, Pellegrini N. A review of recent studies on malondialdehyde as toxic molecule and biological marker of oxidative stress. Nutrition & Metabolic Cardiovascular Diseases. 2015;15(4):316–328.

Farmer EE, Davoine C. Reactive electrophile species. Current Opinions in Plant Biology. 2007;10(4):380–386. DOI:10.1016/j.pbi.2007.04.019

Muller FL, Lustgarten MS, Jang Y, Richardson A, Van Remmen H. Trends in oxidative aging theories. Free Radical Biology & Medicine. 2007;43(4):477–503. DOI:1016/j.freeradbiomed. 2007.03.034

Bhabak KP, Mugesh G. Functional mimics of glutathione peroxidase: bioinspired synthetic antioxidants. Accounts of Chemical Research. 2010;43(11):1408–1419.
DOI: 10.1021/ar100059g

Wang Y, Walsh SW. Increased superoxide generation is associated with decreased superoxide dismutase activity and mRNA expression in placental trophoblast cells in pre-eclampsia, Placenta. 2001;(22):206- 212.
DOI: 10.1053/plac.2000.0608

Cebovic TN, Maric D, Nikolic A, Novakov-Mikic A. Antioxidant status in normal pregnancy and preeclampsia upon multivitamin supplementation in the region of Vojvodina. Int J Biosc Biochem Bioinform. 2013; 3(2):138-143.

Nodler J, Moolamalla SR, Ledger EM, Nuwayhid BS &Mulla ZD. Elevated antiphospholipid antibody titers and adverse pregnancy outcomes: Analysis of a population-based hospital dataset. Bio Med Catalogue of Pregnancy and Childbirth. 2009;(9):11.

Sapna VA, Sireesha I, Shripad H, Lavanya R, Pratap K, Muralidhar VP . Quantifying Proteinuria in Hypertensive Disorders of Pregnancy. International Journal of Hypertension. 2014;941408:1-10.

Benzie IF, Strain JJ. The ferric reducing ability of plasma (FRAP) as a measure of “antioxidant power”: The FRAP assay. J Analyt Biochem. 1996;239:70-76.
DOI: 10.1006/abio.1996.0292

Gutteridge JMC, Wilkins C. Copper dependent hydroxyl radical damage to ascorbic acid: Formation of a thiobarbituric acid reactive product. FEBS let. 1982:327-340.

Misra HP, Fridovich I. The Role of Superoxide Anion in the Autoxidation of Epinephrine and a Simple Assay for Superoxide Dismutase, the Journal of Biological Chemistry. 1972;247(10):3170 – 3175.

Manafa PO, Okafor CC, Chukwuma GO, Ibeh NC, Ogenyi SI, Nwene EK et al. Assessment of superoxide dismutase activity and total antioxidant capacity in adult male cigarette smokers in Nnewi metropolis, Nigeria. J. of med Research. 2017;3(1):23-26.
DOI: 10.31254/jmr.2017.3109

Rotruk JT, Pope AL, Ganther HC, Hafeman DG, Hoekstro WG. Selenium: Biochemical role as a component of GPx. Science. 1973; (179):588–590.
DOI: 10.1126/science.179.4073.588

Noctor G, Foyer CH. Ascorbate and glutathione: keeping active oxygen under control. Annual Reviews in Plant Physiol and Plant Molecular Biol. 1998;49: 249–279.

Mahdiyeh S, Elham S , Zamzam P. Dietary Antioxidant Capacity and Its Association with Preeclampsia, Clinical Nutritional Resources. 2017;6(1):47–54.
DOI: 10.7762/cnr.2017.6.1.47

Shaarawy M, Aref A, Salem ME, Sheiba M. Radical-scavenging antioxidants in pre-eclampsia and eclampsia. Int J Gynecol Obstet.1998;60(2):123-128. DOI:prg/10.1016/S0020-7292(97)00256-7

Savita RS, Deepika A, Smiti N. Maternal and Perinatal Outcome in Severe Pre-eclampsia and Eclampsia JSAFOG. 2009;1(3):25-28.

Niki E. Biomarkers of lipid peroxidation in clinical material, Biochimica et Biophysica Acta. 2014;1840 (2):809–817 .

Necip I, Nevin I, Mehmet S. The changes of trace elements, malondialdehyde levels and superoxide dismutase activities in pregnancy with or without preeclampsia. Clinical Biochemistry. 2002;35(5):393–397.
DOI: 10.1016/S0009-9120(02)00336-3

Girotti AW. Lipid hydroperoxide generation, turnover, and effector action in biological systems, Journal of Lipid Research. 1998; 39(8):1529–1542.
[PMID: 9717713]

Poranena AK, Ekblad P, Uotila P , Ahotupa M. Lipid peroxidation and antioxidants in normal and pre-eclamptic pregnancies, Placenta. 1996;17(7):401-405.
DOI: 10.1016/So143-4004(96)90021-1

Dantas EMM, Flávio PVM, Queiroz JW, Dantas DLM, Monteiro GRG, Duggal P et al. Preeclampsia is associated with increased maternal body weight in a northeastern Brazilian population.BMC Pregnancy and Childbirth. 2013;13:159.

Giacco F, Brownlee M. Oxidative stress and diabetic complications Circ Res. 2010; 107(9):1058–1070.
DOI: 101161/CIRCRESAHA.110.223545

Hiten DM, Paula JW. The Importance of An oxidant Micronutrients in Pregnancy Oxidative Medicine and Cellular Longevity. 2011;12(1):41-49.
DOI: q0.1155/2011/841749

Mahadik KV, Sina SA. Study of serum levels of superoxide dismutase in preeclampsia and eclampsia: role of the test as a predictive tool. J. Obs Gynae Res. 2003; 29(4):262-267.
[PMID: 12959150]

Rotruck JT, Pope AL, Ganther HE, Swanson AB, Hafeman DG, Hoekstra WG. Selenium: Biochemical role as a component of GPx. Science. 1973;179(4073):588–590.

Krishna TS, Epari VR, Jupalle NN. Alterations of antioxidant enzymes in preeclampsia. Int J Res Med Sci. 2015; 3(9):2348-2351.

Sedighi O, Makhlough A, Shokrzadeh M, Hoorshad S. Association between plasma selenium and glutathione peroxidase levels and severity of diabetic nephropathy in patients with type two diabetes mellitus. Nephro-Urology Monthly.2014;6(5): 36-39.
DOI: 10.5812/numonthly.21355

Walsh SW. Maternal-Placental Interactions of Oxidative Stress and Antioxidants in Preeclampsia Semin Reprod Med. 1998; 16(1):93-104.
DOI: 10.1055/s-2007-1016256

Bullarbo M, Rylander R. Diastolic blood pressure increase is a risk indicator for pre-eclampsia. Arch Obstet Gynecol. 2014; 288:1269–1274.
DOI 10.1007/s00404-014-3476-1