Placental Oxidative Stress in the pathogenesis of Hypertensive Disorders of Pregnancy

Background: Hypertensive disorders of pregnancy are a major complication of pregnancies and can lead to fetal growth retardation, premature delivery and maternal morbidity and mortality. The study aimed at assessing the potential role of the placenta in the pathogenesis of hypertensive disorders of pregnancy. Methods: This study was a case-control study conducted at the Upper East Regional Hospital, Ghana from September, 2016 to March 2017. Twenty (20) pregnant women with hypertensive disorders of pregnancy (i.e., Pregnancy induced hypertension, preeclampsia and eclampsia) as cases and 30 normotensive pregnancies as controls, were included in the study. The placenta was excised after delivery, homogenized and assayed for malondialdehyde, catalase, total peroxide, oxidative stress index, total antioxidant capacity and placental lipid profile. Results: The ages of the two groups were similar, with malondialdehyde (p = 0.001) and Oxidative Stress Index (p < 0.001) being significantly higher in the hypertensive group compared to the control group whereas Total Antioxidant Capacity (p < 0.001) and Catalase (p = 0.011) were significantly higher in the control group compared to the hypertensive group. The proportion of normal, term and livebirth deliveries were significantly higher among controls compared to the hypertensive disorders of pregnancy group. Among the estimated oxidative stress markers, total antioxidant capacity turned out to be the best predictor of the hypertensive disorders of pregnancy. Conclusion: Our findings suggest oxidative stress in women with hypertensive disorders of pregnancy and that placental oxidative stress could be the driving factor for the pathogenesis and severity of these hypertensive disorders of pregnancy.