Introduction: Pregnancy is well-known to increase the oxidative stress, a phenomenon generated by a normal systemic inflammatory response, which results in high amounts of circulating reactive oxygen species (ROS). The major source of ROS during pregnancy is the central organ that regulates this condition, i.e. the placenta. Pregnancy complications including pre-eclampsia, gestational diabetes mellitus, preterm birth, and intrauterine growth restriction can cause acute and chronic health problems for the mother and fetus. Current methods of predicting pregnancy complications are limited and although a large number of factors are associated with disease progression, few biomarkers have been used to aid in disease diagnosis early in gestation. Malondialdehyde (MDA) is formed as a result of lipid peroxidation of polyunsaturated fatty acids which is commonly used to indicate lipid peroxidation and oxidative stress. In this article role of MDA as a biomarker used in the prediction or diagnosis of pregnancy disorders has been reviewed.
Methods: This article reviewed several articles published from 2015 to 2021 and available in PubMed in English. “Oxidative stress Biomarkers”, “Malondialdehyde”, and “Pregnancy Complications” were searched individually and in combination as keywords to find most related articles.
Results: MDA levels in second trimester women have been shown to be similar in the amniotic fluid of healthy control and pre-eclamptic women. In contrast women with pregnancy induced hypertension were found to have lower levels of MDA within amniotic fluid compared with controls. several studies have found elevated levels of MDA in serum/plasma of women with pregnancy disorders. Karowicz-Bilinska, demonstrated elevated serum MDA levels in women with IUGR. Pathak et al. similarly demonstrated that maternal blood MDA levels are increased at birth in women with preterm deliveries compared with women at full term.
Conclusion: Markers of oxidative stress are frequently reported as being increased in biological fluids of women with one or more of the above pregnancy complications. Many of the studies performed have focused on preeclampsia, but it is likely that an increase in any of the markers of oxidative stress would also be increased in a number of pregnancy complications. MDA in blood may prove to be a useful indicator of adversity during pregnancy; however, studies have highlighted some shortcomings in analyzing this biomarker, most notably because MDA is a specific measure of lipid peroxidation and the most commonly used thiobarbituric acid reactive substance assay is not highly specific for MDA. As such, further studies need to be performed to investigate suitability of this marker and to determine how useful it would be in a diagnostic setting. The establishment of viable predictive biomarkers of pregnancy disorders may allow for the use of prophylactic treatment options while diagnostic markers may prove useful for the
determination of individualized treatment strategies.