title: Reduced glutathione in hepatitis E infection and pregnancy outcome.
abstract: OBJECTIVE
  To study reduced glutathione (GSH) as a marker of oxidative stress in hepatitis E virus (HEV) infection during pregnancy, and to clarify its association with pregnancy outcome.
  
  
  METHODS
  A total of 30 pregnant and 30 non-pregnant women with HEV infection were enrolled in the present study, along with 30 age- and gestation-matched healthy pregnant controls. Serum GSH was measured using commercially available enzyme-linked immunoassay kit.
  
  
  RESULTS
  Significantly lower GSH was observed in HEV-infected pregnant women than in healthy pregnant controls (10.44 ng/mL vs 19.77 ng/mL; P < 0.01). No significant association was observed between GSH and pregnant women and non-pregnant women with HEV infection (P = 0.54). Serum GSH ≤10.88 ng/mL was more likely to be associated with HEV infection during pregnancy, with sensitivity and specificity of 73.3%. Lower GSH was observed in pregnant women with HEV infection having preterm delivery and low birthweight newborns compared with healthy pregnant women (P < 0.01 and P < 0.05, respectively). Serum GSH was lower in pregnant women with HEV infection who had stillbirth compared with those having live births (7.21 ng/mL vs 6.12 ng/mL, P = 0.60).
  
  
  CONCLUSIONS
  Oxidative stress is present in HEV infection during pregnancy, as shown by low GSH, and is associated with adverse pregnancy outcomes. Serum GSH ≤10.88 ng/mL during pregnancy can be used for risk stratification for HEV infection.
authors.affiliation: Department of Obstetrics and Gynecology, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Gunjan
authors.initials: G
authors.lastname: Bhatnagar
authors.affiliation: Department of Obstetrics and Gynecology, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Sheetal
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Obstetrics and Gynecology, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Obstetrics and Gynecology, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Sudha
authors.initials: S
authors.lastname: Prasad
authors.affiliation: Department of Biochemistry, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Sarita
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Department of Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Premashish
authors.initials: P
authors.lastname: Kar
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D005978:Glutathione / Q000097:blood*; D016751:Hepatitis E / Q000150:complications*; D006801:Humans; D007230:Infant, Low Birth Weight; D050498:Live Birth; D018384:Oxidative Stress; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood* / Q000821:virology*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000097:blood / Q000821:virology; D050497:Stillbirth; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005978:Glutathione
keywords: acute liver failure; acute viral hepatitis; hepatitis E virus; pregnancy; reduced glutathione