Counteracting oxidative stress in pregnancy through modulation of maternal micronutrients and omega-3 fatty acids

During pregnancy, oxidative stress has been implicated in the pathophysiology of preeclampsia and preterm birth leading to poor birth outcome. Hyperhomocysteinemia caused as a consequence of altered micronutrients like folic acid and vitamin B12 is associated with increased production of reactive oxygen species that generate oxidative stress. These micronutrients are important determinants of methyl donor, s-adenosyl methionine while phospholipids are important methyl acceptors in the one-carbon metabolic cycle. A series of our studies in women during pregnancy have demonstrated altered levels of these micronutrients and the negative association of docosahexaenoic acid with homocysteine. Various strategies to counteract oxidative stress during pregnancy such as antioxidant therapy have been examined and found to be inconsistent. In this review, we focus on the role of oxidative stress in pregnancy and discuss the possibility of ameliorating it through modulation of maternal micronutrients and omega 3 fatty acids especially docosahexaenoic acid. We propose for the first time that manipulation of one-carbon metabolism by maternal diet could be a potential mechanism to counteract oxidative stress through homocysteine lowering effects and help in reducing the risk for adverse pregnancy outcomes.