title: ASSESSMENT OF OXIDATIVE STRESS IN EARLY AND LATE ONSET PRE-ECLAMPSIA AMONG GHANAIAN WOMEN.
abstract: BACKGROUND
  Pre-eclampsia is a multisystem pregnancy-related disorder with multiple theories regarding its aetiology resulting in lack of reliable screening tests and well-established measures for primary prevention. However, oxidative stress is increasingly being implicated in the pathogenesi of pre-eclampsia although conflicting findings have been reported.
  
  
  OBJECTIVE
  To determine and compare the levels of oxidative stress in early and late onset pre-eclampsia by measuring urinary excretion of isoprostane and total antioxidant power (TAP) in a cohort of pre-eclamptic women at Korle Bu Teaching Hospital.
  
  
  METHODS
  This was a cross-sectional study conducted at Korle-Bu Teaching Hospital, Accra, Ghana involving pre-eclamptic women between the ages 18 and 45 years who gave written informed consent. Urinary isoprostane levels were determined using an enzyme-linked immunosorbent assay (ELISA) kit whereas the Total Anti-oxidant Power in urine samples was determined using Total Antioxidant Power Colorimetric Microplate Assay kit. The data obtained were analyzed using MEGASTAT statistical software package.
  
  
  RESULTS
  We included 102 pre-eclamptic women comprising 68 (66.7%) and 34 (33.3%) with early-onset and late-onset pre-eclampsia respectively. There were no statistically significant differences between the mean maternal age, haematological indices, serum ALT, AST, ALT, albumin, urea, creatinine uric acid and total protein at the time of diagnosis. The mean gestational age at diagnosis of early and late onset pre-eclampsia were 31.65 ± 0.41 and 38.03 ± 0.21 respectively (p ˂ 0.001). Also, there were statistically significant differences between the diastolic blood pressure (BP), systolic BP and mean arterial pressure (MAP) at diagnosis of pre-eclampsia in the two categories. The mean urinary Isoprostane excretion was significantly higher in the early onset pre-eclamptic group (3.04 ± 0.34 ng/mg Cr) compared to that of the late onset pre-eclamptic group (2.36 ± 0.45 ng/mg Cr), (p=0.019). Urinary total antioxidant power (TAP) in early onset PE (1.64 ± 0.06) was lower but not significantly different from that of late onset PE (1.74 ± 0.09) with p = 0.369.
  
  
  CONCLUSIONS
  Significantly increased urinary isoprostane excretion was detected in early onset pre-eclampsia compared to late onset pre-eclampsia, suggestive of increased oxidative stress in the former. However, there was no significant difference in total anti-oxidant power between the two categories of pre-eclampsia women although there was a tendency of reduced total antioxidant power in the women with early onset pre-ecalmpsia.
authors.affiliation: Department of Physiology, School of Biomedical and Allied Sciences, University of Ghana ; Dept. of Medical Oncology, Dana Farber Cancer Institute, Harvard Institute of Medicine, Boston, USA.
authors.forename: P W
authors.initials: PW
authors.lastname: Tetteh
authors.affiliation: Department of Physiology, School of Biomedical and Allied Sciences, University of Ghana ; Department of Obstetrics and Gynecology, Korle Bu Teaching Hospital, Accra, Ghana.
authors.forename: K
authors.initials: K
authors.lastname: Adu-Bonsaffoh
authors.affiliation: Department of Physiology, School of Biomedical and Allied Sciences, University of Ghana.
authors.forename: C
authors.initials: C
authors.lastname: Antwi-Boasiako
authors.affiliation: Department of Physiology, School of Biomedical and Allied Sciences, University of Ghana.
authors.forename: D A
authors.initials: DA
authors.lastname: Antwi
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine and Dentistry, University of Ghana.
authors.forename: B
authors.initials: B
authors.lastname: Gyan
authors.affiliation: Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana.
authors.forename: S A
authors.initials: SA
authors.lastname: Obed
keywords: Pre-eclampsia; isoprostane; oxidative stress; total anti-oxidant power