title: Role of antioxidants in gestational diabetes mellitus and relation to fetal outcome: a randomized controlled trial.
abstract: OBJECTIVE
  To examine the effect of antioxidant administration on the oxidative parameters in both blood and placental tissue and its relation to fetal outcome in women with GDM.
  
  
  METHODS
  Two-hundred pregnant women with gestational diabetes mellitus (GDM) were randomized into 2 groups, Group1 received 1 gram L-ascorbic acid per day and Group2 received placebo.
  
  
  RESULTS
  The use of antioxidants significantly lower the needed insulin dose for blood sugar control (25.6 ± 20.3 versus 40.5 ± 23.7, respectively). In placental tissue homogenates, glutathione (GSH) was 49.6 ± 5.9 versus 62.34 ± 4.99, malondialdahyde (MDA) was 165.7 ± 9.2 versus 264.15 ± 12, superoxide dismutase (SOD) was 0.3 ± 0.3 versus 0.054 ± 0.16 while catalase (CAT) was 14.06 ± 2.4 versus 15.52 ± 3.97 and glutathione peroxidase (GPx) was 14 ± 4.1 versus 26.3 ± 4.26 in antioxidant group compared to the control group (p < 0.001). In maternal blood, GSH was 1.5 ± 0.3 versus 0.74 ± 0.088, CAT was 380.7 ± 11 versus 325.44 ± 21.8, GPx was 52.3 ± 8.7 versus 75.82 ± 6.84 and SOD was 188 ± 15.3 versus 98.56 ± 11.05 in antioxidant group compared to control group (p < 0.001). In neonatal blood, the level of MDA and SOD showed a statistically significant difference between antioxidants and control groups (4 ± 0.7 versus 6.6 7 ±0.66 and1 8 8 ± 15.3 versus 98.5 ± 11.05, respectively) (p < 0.001). The neonatal blood sugar after 1 and 2 hours of delivery was more stable in antioxidant group (56.7 ± 10.9 versus 39.7 ± 11.1 and 58.5 ± 10.8 versus 41.7 ± 13.1, respectively) (p <0.05). The neonates NICU admission was lower in antioxidant group (5 versus 11) (p <0.05).
  
  
  CONCLUSIONS
  The use of antioxidants markedly reverses the oxidative stresses in women with GDM with marked improvement on neonatal outcome.
authors.affiliation: a Obstetrics and Gynecology Department, Kasr Aini Hospital Cairo University , Cairo , Egypt .
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Maged
authors.affiliation: b Obstetrics and Gynecology Department, 6th October University , Cairo , Egypt .
authors.forename: Haitham
authors.initials: H
authors.lastname: Torky
authors.affiliation: a Obstetrics and Gynecology Department, Kasr Aini Hospital Cairo University , Cairo , Egypt .
authors.forename: Mona A
authors.initials: MA
authors.lastname: Fouad
authors.affiliation: a Obstetrics and Gynecology Department, Kasr Aini Hospital Cairo University , Cairo , Egypt .
authors.forename: Sherine H
authors.initials: SH
authors.lastname: GadAllah
authors.affiliation: c Pediatric Department, 6th October University , Cairo , Egypt , and.
authors.forename: Nevien M
authors.initials: NM
authors.lastname: Waked
authors.affiliation: c Pediatric Department, 6th October University , Cairo , Egypt , and.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: Gayed
authors.affiliation: d Physiology Department, 6th October University , Cairo , Egypt.
authors.forename: Ashraf K
authors.initials: AK
authors.lastname: Salem
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000494:pharmacology*; D001205:Ascorbic Acid / Q000494:pharmacology*; D001786:Blood Glucose / Q000187:drug effects*; D016640:Diabetes, Gestational / Q000628:therapy*; D005260:Female; D005333:Fetus / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening; D018384:Oxidative Stress / Q000187:drug effects*; D010920:Placenta / Q000378:metabolism*; D011247:Pregnancy; D011256:Pregnancy Outcome; D013482:Superoxide Dismutase / Q000378:metabolism; D016216:Ultrasonography, Prenatal; D055815:Young Adult
chemical_list: D000975:Antioxidants; D001786:Blood Glucose; D013482:Superoxide Dismutase; D001205:Ascorbic Acid
keywords: Antioxidants; fetal outcome; gestational diabetes; oxidative stress