Development of preeclampsia prediction during the first trimester of pregnancy - the role of oxidative stress biomarkers in preeclampsia prediction

[V. I. Dimitrov]

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Mnogo različitih faktora doprinosi razvoju preeklampsije zbog čegaje od izuzetnog značaja prepoznati trudnice sa povećanim rizikombudućidaone zahtevaju intenzivniji nadzor, a u nekim slučajevima i preduzimanjepreventivnih mera. Uočena je i visoka korelacija između pojavepreeklampsije i ekspresije gena uključenih u različite upale, oksidativnistres, trombofiliju i put regulacije krvnog pritiska–renin/angiotenzin/aldosteron. Osnovni cilj ovog istraživanja je validacija i razvijanje instrumentapomoću kojeg bi bilo moguće predvideti u ranoj trudnoćiozbiljnekomplikacije i poremećaje u trudnoći, kao što je preeklampsija, aliipronaći algoritam maternalnih, fetalnih, antropometrijskih i specifičnihbiohemijskih parametara, a koji bi mogao biti pouzdan skrining modelzatrudnice u proceni rizika za razvoj placentarne disfunkcijei/ilipreeklampsije. Ovim istraživanjem može se uočiti značaj praćenja različitihantropometrijskih parametara, kao i parametara placente (β-HCGiPAPP-A)merenih u prvom trimestru trudnoće u predviđanju nastanka preeklampsijekod trudnica. Na osnovu našeg istraživanja sprovedenog na osnovu upitnikazasuboptimalni zdravstveni status, zasnovanog na 25 pitanja (SHSQ-25) ipetdomena, najveću prosečnu vrednost je pokazao domen digestivnog trakta, štoje važno sa aspekta literaturne informacije da je mikrobiotacrevapovezana sa regulacijom metabolizma domaćina i da igra važnu uloguupovišenju krvnog pritiska generalno i tokom trudnoće, što je iobeležjepreeklampsije. Dalja istraživanja bi trebalo da se fokusiraju na definisanjenajboljeg algoritma koji bi mogao da se primeni prilikom procene akojibiimao najveću prediktivnu moć

Many different factors contribute to the development of preeclampsia, whichis why it is extremely important to recognize pregnant women with an increasedrisk, since they require more intensive monitoring, and in some cases, taking preventivemeasures. A high correlation was observed between the onset of preeclampsiaandthe expression of genes involved in various inflammations, oxidativestress, thrombophilia and the blood pressure regulation pathway- renin/angiotensin/aldosterone. The main goal of this research is the validation and development of aninstrument with which it would be possible to predict in early pregnancy seriouscomplications and disorders in pregnancy such as preeclampsia, but alsotofindanalgorithm of maternal, fetal, anthropometric and specific biochemical parametersthat could be a reliable screening model for pregnant women in risk assessment forthe development of placental dysfunction and/or preeclampsia. This research shows the importance of monitoring various anthropometricparameters, as well as placental parameters (β-HCG and PAPP-A) measuredinthefirst trimester of pregnancy in predicting the occurrence of preeclampsia inpregnantwomen.Based on our research conducted on the suboptimal healthstatusquestionnaire, based on 25 questions (SHSQ-25) and five domains, thehighestaverage value was shown by the domain of the digestive tract, which is importantfrom the point of view of the literature information that the intestinal microbiotaisrelated to the regulation of the host's metabolism and that it plays an important rolein the increase of blood pressure in general and during pregnancy, whichisalsoafeature of preeclampsia. Further research should focus on defining the best algorithmthat couldbeapplied in the assessment and that would have the highest predictive power.

oksidacioni stres, trudnoća, placentarni faktori, suboptimalni zdravstveni status.

oxidative stress, pregnancy, placental factors, suboptimal healthstatus.

618.5-089.888.61:615(043.3)

Ginekologija i akušerstvo

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