Evaluation of oxidative stress markers in subtypes of preeclampsia: A systematic review and meta-analysis

Studies about oxidative stress biomarkers revealed different phenotypes between early and late preeclampsia (PE). Despite that, there is extensive evidence of oxidative stress in investigations that combinate forms different of preeclampsia. This study reviews the oxidative stress profile in the PE subtypes and evaluates which markers are altered in the blood and placental tissue. A search was conducted in databases such as MEDLINE, EMBASE, LILACS, and Web of Science without restricting the year and language of publication. The quality of the studies was evaluated by the Newcastle-Ottawa scale and Joanna Briggs Institute for analytical Cross-Sectional Studies. After 13,319 screened records, 65 were included in the systematic review. The markers of stress oxidative of damage and reactive species were those selected, such as malondialdehyde (MDA), lipid peroxide, advanced protein oxidation products, carbonyl protein, 8-hydroxy-2 '-deoxyguanosine, total oxidant status, hydrogen peroxide, nitric oxide (NO). We described the antioxidant activity, including the superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione-S-transferase, free glutathione, and total antioxidant capacity (TAC). We results demonstrated that oxidative stress is related to pathophysiology of PE, there were increased lipid peroxidation in the blood and placenta, and in blood a reduction of NO levels and of TAC, like lower enzymatic activity of GPx, CAT in PE, and SOD in mild PE. In addition, altered levels of MDA in the placenta and blood show that placental changes have repercussions on the clinical syndrome and are related to the severity of the disease.

Automated summary

Studies on oxidative stress biomarkers have shown that there are different phenotypes between early and late preeclampsia (PE). This study aimed to review the oxidative stress profile in different subtypes of PE and identify the markers that are altered in blood and placental tissue. A literature search was conducted without restrictions on year and language of publication. After screening a total of 13,319 records, 65 studies were included in the systematic review. The results showed that oxidative stress is closely related to the pathophysiology of PE, with increased lipid peroxidation in blood and placenta, reduced levels of nitric oxide (NO) and total antioxidant capacity (TAC) in blood, as well as lower enzymatic activity of glutathione peroxidase (GPx), catalase (CAT), and superoxide dismutase (SOD) in PE.