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Citation: Rodríguez-Rodríguez P, Ramiro-Cortijo D, Reyes-Hernández CG, López de Pablo AL, González MC and Arribas SM Implication of Oxidative Stress in Fetal Programming of Cardiovascular Disease.

Received: 30 January ; Accepted: 03 May ; Published: 23 May Copyright © Rodríguez-Rodríguez, Ramiro-Cortijo, Reyes-Hernández, López de Pablo, González and Arribas. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY.

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Top bar navigation. Chitra et al found higher MDA plasma levels in neonate than in the maternal plasma. Uterine contractions produce a fluctuation in uterine blood flow ischemia followed by reperfusion , a process known to generate free radicals.

In uncomplicated births, oxidative stress is more effectively counterbalanced by the body's antioxidant power, compared to complicated births 3. The evaluation of oxidative stress based on the level of peroxidation is conducted by determining malondialdehyde MDA levels.

MDA is a product of the lipid peroxidation process along with other aldehydes and is frequently and preferentially used as a biochemical marker to assess the intensity of this process 7. In a review by Gitto et al elevated MDA concentrations were described in distressed fetuses delivered by emergency Caesarean section compared to non-distressed newborns delivered by elective Caesarean section 2.

Lurie et al described that as the result of increased distress, MDA levels and glutathione oxidase activity of amniotic fluid and cord blood were elevated in case of fetuses born via emergency caesarian section, and that gender or type of anesthesia had no influence on the concentration of these biomarkers Karacor et al concluded in their study that MDA levels were significantly higher in pregnant women who underwent oxytocin-induced labor compared to the control group, which implies that the administration of oxytocin leads to maternal and fetal stress, which is why the concentration of MDA is increased 7.

Another study by Schneid-Kofman et al also describes higher concentrations of MDA in pregnant women with induced labor, but with low level of the antioxidant glutathione Glutathione is important in stopping the lipid peroxidation process, in which the starting free radical is regenerated and available to restart another lipid peroxidation process, by reacting with the lipid peroxide intermediates and preventing the perpetuation of the process.

According to Rogers et al the increase in MDA levels in the umbilical cord blood may suggest a state of hypoxia and may also be caused by perinatal stress According to Chitra et al MDA levels in maternal and fetal plasma were significantly different.

Based on this difference, birth predisposes the fetus to more intense oxidative stress compared to pregnant women, but the oxidative status of both mother and fetus is significantly altered 3. In a study of the oxidative status of low-birth-weight infants LBW , Negi et al reported that MDA plasma concentrations were higher in LBW infants compared to a normal birth-weight control group, and at the same time they have found decreased levels of TAS, and vitamins A, E and C dietary antioxidants According to Wilinska et al plasma MDA levels were elevated in full-term infants and their mothers, but MDA levels in breast milk decreased in the first days after birth, probably due to the reduced metabolic need.

It was also observed that breast milk has high antioxidant content, at least in the first couple of days after birth, which is beneficial to the newborn According to Howlander et al maternal and fetal oxidative stress in cases of preeclampsia was characterized by increased serum MDA levels in both mother and fetus, compared to a healthy control group.

At the same time, an increase in ROS and decrease in TOS and vitamin C levels were observed in the fetal circulation, and protein carbonyl levels were significantly higher compared to the control group TAS also mentioned by some authors as total antioxidative capacity and TOS or total oxidative capacity were studied by multiple authors.

According to Alberti-Fidanza et al the diet of pregnant women significantly influenced the total antioxidant capacity, which was much higher in mothers who had a diet rich in vitamins However, this should also be correlated with the meta-analysis of Bjelakovic et al who reported that high consumption of antioxidant supplements vitamin A, E may be associated with increased mortality, and that the potential role of vitamin C in decreasing life expectancy of well-nourished adults, needs further investigations.

Antioxidant source should be dietary and not from supplements, the authors suggest According to Özalkaya et al TOS is much higher in cases of premature rupture of membranes and TAS is lower in cases of premature rupture of membranes and fetal inflammatory response syndrome.

Also, they suggest that oxidative stress is responsible for the premature ageing of the fetal membranes of infants born before 34 weeks of gestation This thesis is also supported by a number of studies carried out by Menon and Richardson 58 and Ilhan et al According to Wilinska et al TAS has a declining trend in newborns during the first days of life The study of Arguelles et al concluded that based on TAS, under normal conditions, the level of maternal and fetal oxidative stress displays no significant differences, but an excess of maternal oxidative stress caused by smoking, inappropriate lifestyle, diabetes mellitus, metabolic diseases causes even more severe fetal oxidative stress at birth; therefore, monitoring and control of maternal oxidative stress during pregnancy is important According to Howlander et al TAS was significantly lower in pregnant women with preeclampsia, which demonstrates that preeclampsia is an important perinatal pathology, which causes extra stress to both the maternal and fetal organism In the study by Seligman et al NO levels were lower in preeclamptic women than in healthy pregnant ones 60 , in accordance with the findings of Conrad et al who described lower levels of NO and cGMP in preeclamptic patients In their study Karacor et al found no statistically significant difference in NO levels between the oxytocin-induced labor group and control group, thus they suggested that antioxidant mechanisms were functioning well in both groups and stress only is not enough to cause alteration in NO levels 7.

Upon the attempt to summarize the results of studies performed on pregnant women and newborns, we conclude that all these studies underline the need to understand the mechanisms of action of free radical formation and their action on the maternal and fetal organism, in order to identify strategies to reduce the level of oxidative stress, and minimize the harmful effects of this process on both mother and newborn.

The authors of this review confirm that all information found in this review is documented by relevant references. ZSS performed analysis of the current published data. ZSS and MC drafted the original manuscript. EF, ENN and LD performed critical revision of the manuscript.

BS provided expertise in the field of obstetrics. All authors read and approved the final manuscript. Fogarasi E, Croitoru MD, Fülöp I and Muntean DL: Is the oxidative stress really a disease?

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Reactive oxygen species Role of free radicals in prenatal development are Sugar level testing strips, short-lived, and Fadicals diffusible molecules that are ftee as natural by-products of aerobic respiration and metabolism. The control of ROS production Rple antioxidants is prenaal Cancer-fighting superfoods element for aerobic dvelopment. Adverse prenatal developmental outcome Rol one of the major concerns in reproductive Rope and health. The frwe of the developing organism in utero from ROS-induced oxidative damage is ensured by antioxidant systems to cope with locally produced ROS and prevent their overproduction and propagation to highly reactive and toxic ROS. Maternal exposure to multiple environmental factors contributes to adverse prenatal developmental outcomes, at least in part, via ROS generation. ROS-induced oxidative damage is considered to be a promoter of several prenatal developmental disorders, including defective embryogenesis, embryopathies, embryonic mortality, spontaneous abortion, recurrent pregnancy loss, fetal growth restriction, intrauterine fetal death, preterm delivery, and low birth weight. In this chapter, the roles of ROS and antioxidant systems in prenatal developmental outcomes are reviewed.