Antioxidants in pregnant women with hyperemesis gravidarum

ABSTRACT

Hyperemesis gravidarum [HG] is relatively a syndrome of unknown cause, and is generally self-limiting. The aim of this study was to evaluate the oxidative status of those patients with HG, to compare those values with matched normal pregnant women and to evaluate the effect of vitamin E as an antioxidant on this syndrome. Measurement of serum vitamin E [vit E] by using High Performance Liquid Chromatography [HPLC], blood reduced glutathione [GSH] and plasma thiobarbituric acid [TBBA] were assayed by the chemical methods, serum zinc [Zn] was measured by atomic absorption spectrophotometry and fasting plasma tumor necrosis factor-alpha [TNF-alpha] by immunoenzymometric assay [EASIA]. They were assessed in normal healthy pregnant women [group I; n=15] and women who had positive obstetric history of hyperemesis in the previous pregnancies HG [group II; n=30]; they were recruited and counseled to commence the use of antiemetics as soon as they became aware of the present pregnancy, and no later than the beginning of symptoms. Women of HG group were further subdivided into 2 main groups; [the study group n=15] included pregnant patients who used antiemetics besides vitamin E capsules [HG-E group] and [the control group n=15] who were not supplemented with vitamin E [HG group]. Follow up of all pregnant women was done. The same measurements were re-evaluated in both hyperemetic groups when the symptoms had been improved. At the start of the study, serum vitamin E, serum Zn and blood GSH levels were significantly lower in hyperemesis gravidarum groups [n=30] when compared to NHP women [n=15], while both TBBA and TNF- were significantly higher. After the symptoms had been improved, blood GSH, serum Zn and serum vitamin E levels were significantly higher while TBBA, and TNF- alpha levels became significantly lower with vitamin E administration in HG-E [n=15]. Also, the signs and symptoms of nausea and vomiting rapidly improved and they required lesser period for hospitalization in HG-E group versus HG [the controls]; reflecting the significant decrease in oxidative stress among HG-E group. There were significantly inverse correlation between both serum zinc and vitamin E with TNF-alpha and TBBA, and significant positive correlations between serum vitamin E with serum zinc and GSH in HG-E group. Patients with HG are exposed to oxidative stress, which may have a role in the pathogenesis of the disease. Supplementation with the antioxidant vitamin E could be considered in the treatment of HG and to he routinely administered in the early pregnancy