title: Oxidative stress, diet, and the etiology of preeclampsia.
abstract: BACKGROUND
  A current theory holds that oxidative stress, ie, an imbalance between maternal prooxidants and antioxidants, is a component of preeclampsia. It is uncertain whether such an imbalance occurs before clinical recognition of the syndrome or whether it is related to diet.
  
  
  OBJECTIVE
  We measured urinary excretion of the isoprostane 8-iso-prostaglandin F(2alpha), which is an indicator of oxidative damage to lipids, and the total antioxidant power, which is a global measure of antioxidant status, at the entry to prenatal care. We also examined the relation of these indexes to diet during pregnancy.
  
  
  METHODS
  A cohort of 307 gravidae from Camden, NJ, was studied from entry to prenatal care (at 15.0 +/- 0.49 wk gestation). Measures of the maternal diet were obtained by 24-h recall.
  
  
  RESULTS
  Risk of preeclampsia was increased 5-fold with higher urinary isoprostane excretion and decreased 3-fold with higher total antioxidant power. Over the course of pregnancy, there were significant trends for an association of higher isoprostane excretion with increased consumption of energy-adjusted fat, polyunsaturated fat, and polyunsaturated fatty acids (n-3, n-6, and linoleic and linolenic fatty acids), whereas total antioxidant power was not related to diet.
  
  
  CONCLUSIONS
  Increased urinary excretion of isoprostane and decreased antioxidant production is an imbalance that is consistent with oxidative stress, and it precedes clinical recognition of preeclampsia. The maternal diet is an underlying factor that provides an environment for free radical generation.
authors.affiliation: Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine, Stratford, NJ USA. scholl@umdnj.edu
authors.forename: Theresa O
authors.initials: TO
authors.lastname: Scholl
authors.forename: Maria
authors.initials: M
authors.lastname: Leskiw
authors.forename: Xinhua
authors.initials: X
authors.lastname: Chen
authors.forename: Melissa
authors.initials: M
authors.lastname: Sims
authors.forename: T Peter
authors.initials: TP
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000975:Antioxidants / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D015331:Cohort Studies; D004032:Diet; D015237:Dinoprost / Q000031:analogs & derivatives* / Q000378:metabolism / Q000652:urine; D005260:Female; D006801:Humans; D016014:Linear Models; D050356:Lipid Metabolism; D015227:Lipid Peroxidation; D039382:Maternal Nutritional Physiological Phenomena; D011939:Mental Recall; D018384:Oxidative Stress / Q000502:physiology*; D011225:Pre-Eclampsia / Q000209:etiology* / Q000378:metabolism; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D000975:Antioxidants; D015415:Biomarkers; C075750:8-epi-prostaglandin F2alpha; D015237:Dinoprost