Maternal Serum and Cord Blood Homocysteine and MDA Levels as Markers of Oxidative Stress in Normal Vs High Risk Deliveries

Anuva Mishra, P.K. Mishra, A. K. Rath

Lipid peroxidation is a normal phenomenon occurring continuously at low level in all human beings, which is effectively counteracted by antioxidant mechanisms. Oxidative stress is implicated in development of utero-placental disorders which can be a cause of high-risk or abnormal pregnancies. In this study malondialdehyde (MDA) and homocysteine levels in maternal plasma and cord blood at labour were taken as markers of oxidative stress, Also uric acid. Aspartate amino-transferase (AST) and Alanine amino-transferase(ALT),  levels were assessed to co-relate with the incidence of high- risk pregnancies. 46 pregnancies resulting in high-risk deliveries (pre-term, twin , pregnancy-induced hypertension, abruptio placentae, placenta praevia , premature rupture of membrane, prolonged 2nd stage of labour , meconium stained liquour , low APGAR score of baby  at 1 minute, instrumental deliveries)  were taken as cases and  54 age-matched mothers with  normal vaginal delivery were taken as controls. Levels of MDA and homocysteine were found to be significantly higher in cases (MDA: 5.21 ± 0.39 nmol/ ml, homocysteine: 6.01 ± 0.63 nmol/ ml) as compared to controls (MDA :-3.5 ± 0.76 nmol/ ml, homocysteine: 4.62 ± 0.72 nmol/ ml )  with ‘p’ value <0.05.  The level of AST was also significantly higher and uric acid levels were slightly lower in the cases than controls. There was strong positive correlation between maternal homocysteine and MDA values (r = 0.72) and moderate negative correlation between homocysteine and uric acid values (r = - 0.37). These results indicate the association of oxidative stress in cases of high-risk pregnancy outcome and strongly advocate the evaluation of these parameters in ante-partum period and their proper management. It also emphasizes the role of antioxidants in preventing high-risk pregnancies. 

MDA- Malondialdehyde Hcy – Homocysteine High-risk delivery Vs Normal vaginal delivery.