Role of Pro-oxidant Myeloperoxidase and an Oxidative Stress Marker Malondialdehyde in Prediction of Preeclampsia

Abstract

Aim of the Study: The treatment of preeclampsia (PE) is symptomatic till date, as the etiology of this condition has remained elusive for many centuries. Appreciating polymorphonuclear activation and oxidative stress as the early events in the pathogenesis of preeclampsia, we hypothesized that the activity of Myeloperoxidase (MPO), a pro-oxidant enzyme and Malondialdehyde (MDA), an oxidative stress marker may be elevated in preeclamptic subjects. Hence, we set out to estimate their levels in a representative sample of south Indian women with preeclampsia and compare them with controls (uncomplicated, normotensive pregnant women of more than 20 weeks of gestation).  Study Design: Cross sectional study. Place and Duration of Study: Pregnant women attending the Antenatal clinic of Rajarajeswari Medical College and Hospital, Bengaluru, from May 2012 to May 2013 were our study subjects. Materials and Methods: Fifty uncomplicated, normotensive pregnant women of more than 20 weeks of gestation and fifty clinically diagnosed cases of preeclampsia were our controls and cases respectively. Pregnant women with medical conditions that interfere with the study were excluded. Serum MPO activity and MDA levels were estimated manually by spectrophotometric method. Results: There was significant (P<0.001) increase in MPO levels and MDA levels in preeclampsia patients compared to controls. Conclusion: There was increase in pro-oxidant and oxidative stress marker levels indicating an oxidative stress in PE. Thus this study shows that oxidative stress may play a key role in the pathogenesis of PE which contributes to endothelial dysfunction and maternal signs and symptoms.  Estimation of MPO and MDA in early pregnancy may help in identifying pregnant women at risk of developing preeclampsia and execution of preventive measures.