Trophoblast oxidative stress, antioxidants and pregnancy outcome--a review.

Placental oxidative stress has been implicated in pre-eclampsia and miscarriage. The review briefly summarizes the definition of oxidative stress, methods of estimation and likely sources in the placenta. Experimental evidence favouring a role for trophoblast oxidative stress in pre-eclampsia includes reports of lipid peroxidation and deficiencies in antioxidant defences. The potential sources of free radical generation include enhanced enzymatic synthesis of superoxide by xanthine oxidase and NAD(P)H oxidase. Studies employing immunohistochemical markers of oxidative stress also implicate free radical induced damage in placentae from women with early pregnancy loss. The overwhelming evidence for oxidative stress in the placenta and the maternal circulation in pre-eclampsia has led to the suggestion that antioxidant prophylaxis may prevent oxidant stress and so ameliorate or prevent the disease. Several clinical trials currently underway will not only determine whether antioxidants are of use in pre-eclampsia prevention but also provide an ideal opportunity to investigate the aetiology and consequences of trophoblast oxidative stress.