The role of lipid oxidation and oxidative lipid derivatives in the development of preeclampsia.

Preeclampsia develops as a consequence of an exceptionally complex interaction between a multiplicity of factors that originate in 2 genetically different individuals (the mother and the fetus). Oxidative stress/oxidative lipid derivatives may represent one group of such factors. The evidence for a role of oxidative stress/oxidative lipid derivatives in the pathogenesis of preeclampsia may be summarized as follows: In women with established preeclampsia there is good evidence of increased oxidative stress/oxidative lipid derivatives in the decidual-placental tissues. Likewise, in the systemic circulation of women with established preeclampsia most of the studies although not all, indicate elevated levels of oxidative lipid derivatives and reduced anti-oxidative capacity. Because almost all studies on the role of oxidative stress in the pathogenesis of preeclampsia have been among women with established preeclampsia, it remains uncertain whether enhanced oxidative stress is present before clinical signs of preeclampsia develops. One controlled randomized study in which antioxidants were used to treat severe preeclampsia showed nonsignificant differences in clinical outcomes in favor of antioxidants. Controlled studies on the effectiveness of antioxidants in preventing preeclampsia are lacking. Such studies are of major interest in order to evaluate more definitely the role of oxidative stress/oxidative lipid derivatives in the pathogenesis of preeclampsia.