Role of FRIOS (free radical induced oxidative stress) in outcome of pregnancy induced hypertension cases

Anjana Choudhary, Nidhi Tripathi


Background: The anti-oxidant and the per oxidation product levels both are increased in pregnancy. Much recent works has focused on the role of oxidative disturbance in the preeclampsia and eclampsia. Preeclampsia remains a leading cause of maternal and fetal morbidity and mortality.

Methods: This prospective study was conducted in upper India sugar exchange and maternity hospital, department of Obstetrics and Gynecology, GSVM Medical College, Kanpur in Collaboration with department of pathology, GSVM Medical College, Kanpur (UP), India. All the patients selected for the present study, both from control and study group was in detail with regard the clinical history, general examination, local examination, basic investigation and Specific Investigation, Super Oxide Dismutase (SOD). Blood samples would be collected with the informed consent from control as well as study group for assessment of antioxidant status by determining levels of superoxide dismutase.

Results: The mean age and BMI of control as well as study group is almost same. The incidence of pre-eclampsia and eclampsia in primipara was 29.31 and in multiparous it was 9.52 in all groups. It implies that 95% cases will have improvement in SOD value with mean difference in improvement of at least 0.297807. There is statistically significant difference in mode of delivery by LSCS in study group A as compared to study group B and control in PIH patients. The incidence of complications is significantly higher in Study Group A as compared to control group and Study Group B. There is statistically significant difference in the incidence of preterm birth in study group A as well as Study Group B as compared to control. However, there was no statistically significant difference in the incidence of preterm birth after giving intervention to the study group. When cut off value of SOD enzyme as < 0.578U/mg of protein, sensitivity is 66.07% and specificity as 51.85%.

Conclusions: Vitamin-c supplementation will only prevent PIT in PIH with already reduced antioxidant status.


Oxidative stress, Preeclampsia, Superoxide dismutase

Full Text:



Aisen P. Albert Einstein College of Medicine of Yeshiva University. The Biological Chemistry of Iron: A Look at the Metabolism of Iron and Its Subsequent Uses in Living Organisms. 1982;89:63.

Villar K, Say L, Gu¨lmezoglu AM, Merialdi M, Lindheimer MD, Betran AP, Piaggio G. Eclampsia and pre-eclampsia: a health problem for 2000 years. In: Critchley H, MacLean AB, Poston L, Walker JJ, eds. Preeclampsia. London: RCOG Press; 2003:189-207.

Brigelius-Flohe R, Kelly FJ, Salonen JT, Neuzil J, Zingg JM, Azzi A. The European perspective on vitamin E: current knowledge and future research. Am J Clin Nutr. 2002;76:703-16.

Ishihara O, Hayashi M, Osawa H, Kobayashi K, Takeda S, Vessby B, et al. Isoprostanes, prostaglandins and tocopherols in pre-eclampsia, normal pregnancy and non-pregnancy. Free radical research. 2004;38(9):913-8.

Jauniaux E, Hempastock J, Greenwold N, Burton GJ. Trophoblastic oxidative stress in relation temporal and regional differences in maternal placental blood flow in normal and abnormal early pregnancies Am J pathol. 2003;162;115-25.

Cohen G, Heikkila RE. The generation of hydrogen peroxide, superoxide radical, and hydroxyl radical by 6-hydroxydopamine, dialuric acid, and related cytotoxic agents. J Biol Chemist. 1974;249(8):2447-52.

Linder L, Kiowski W, Bühler FR, Lüscher TF. Indirect evidence for release of endothelium-derived relaxing factor in human forearm circulation in vivo. Blunted response in essential hypertension. Circulation. 1990;81(6):1762-7.

Hubel CA. Kagan VE.kisiner. MclaughliN MK. Roberts J.M. Increased ascorbte radical formation and ascorobate depletion in plasma from women with preeclampsia: impoicattions for oxidative stress; Free Radical Biology Medicine. 1997;23(4):597-609.

Poston L, Briley AL, Seed PT. Vitamins in Preeclampsia (VIP) Trial Consortium. Vitamin C and vitamin E in pregnant women at risk for preeclampsia (VIP trial): randomised placebo controlled trial. Lancet. 2006;367(9517):1145-54.

Chappell LC, Seed PT, Briley AL. Effect of antioxidants on the occurrence of preeclampsia in women at increased risk: a randomised trial. Lancet 1999;354(9181):810-6.

Rumbold AR, Crowther CA, Haslam RR, et al. ACTS Study Group. Vitamins C and E and the risks of preeclampsia and perinatal complications. N Engl J Med. 2006;354:1796-1806.

Beazley D, Ahokas R, Livingston J. Vitamin C and E supplementation in women at high risk for preeclampsia: a double-blind, placebo-controlled trial. Am J Obstet Gynecol. 2005;192:520-1.

Gupta S, Aziz N, Sekhon L, Agarwal R, Mansour G, Li J, et al. Lipid peroxidation and antioxidant status in preeclampsia: a systematic review. Obstetr Gynecol Surv. 2009;64(11):750-9.

Marklund SL. Oxygen toxicity and protective systems. J Toxicol Clin Toxicol. 1985;23(4-6):289-98.

Pandey S, Srivastava R, Mukerjee D, Khattri S, Shanker K. Effect of vitamin" A" on free radical cascade in pregnancy induced hypertension. Bollettino chimico farmaceutico. 2000;139(2):98-102.

Wiktor H, Kankofer M. Superoxide dismutase activity in normal and preeclamptic placentas. Ginekologia polska. 1998;69(12):915-8.

Kharb S, Gulati N, Singh V, Singh GP. Superoxide anion formation and glutathione levels in patients with preeclampsia. Gynecologic and obstetric investigation. 2000;49(1):28-30.

Rumiris D, Purwosunu Y, Wibowo N, Farina A, Sekizawa A. Lower rate of preeclampsia after antioxidant supplementation in pregnant women with low antioxidant status. Hypertension in Pregnancy. 2006;25(3):241-53.

Mahadik KV, Ali Sina S. Study of serum levels of superoxide dismutase in preeclampsia and eclampsia: role of the test as a predictive tool. J Obstetrics Gynaecol Res. 2003;29(4):262-7.