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Updated: Oct 18, 2025
Biochemical Measurement of Neonatal Hypoxia
Published on: August 24, 2011
Oxidative stress biomarkers in fetal growth restriction with and without preeclampsia
Mirthe H Schoots1, Martin F Bourgonje1, Arno R Bourgonje2
1Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Insights
Maternal oxidative stress biomarkers, including free thiols (FT) and ischemia-modified albumin (IMA), can help identify pregnancies with fetal growth restriction (FGR) and preeclampsia (PE). FT and leptin show promise in differentiating severe cases.
Area of Science:
- Reproductive Medicine
- Biomarkers
- Oxidative Stress
Background:
- Oxidative stress is implicated in fetal growth restriction (FGR) and preeclampsia (PE).
- Systemic free thiols (FT) and plasma ischemia-modified albumin (IMA) are potential oxidative stress biomarkers.
- Their utility in differentiating pregnancy complications requires evaluation.
Purpose of the Study:
- To evaluate oxidative stress-associated biomarkers for FGR and PE.
- To assess the relationship between these biomarkers and clinical characteristics.
- To determine the discriminative capacity of biomarkers for combined FGR and PE.
Main Methods:
- A prospective clinical pilot study involving healthy controls and women with severe FGR (with or without PE).
- Analysis of blood samples for FT, IMA, sFlt-1, PlGF, leptin, and sRAGE.
- Microscopic examination of placentas and statistical analysis, including receiver operating characteristic (ROC) curves.
Main Results:
- Mothers with severe FGR and PE exhibited significantly reduced FT and PlGF levels.
- Increased levels of IMA, sFlt-1, leptin, and sRAGE were observed in mothers with both FGR and PE compared to FGR only.
- Systemic FT levels inversely correlated with blood pressure, IMA, leptin, and sRAGE.
Conclusions:
- Free thiols (FT), ischemia-modified albumin (IMA), leptin, and soluble receptors for advanced glycation end products (sRAGE) demonstrate significant discriminative capacity.
- These biomarkers hold potential for identifying pregnancies complicated by combined FGR and PE.
Introduction:
Oxidative stress as observed in fetal growth restriction (FGR) and preeclampsia (PE) can be identified by decreased levels of systemic free thiols (FT) and increased levels of plasma ischemia-modified albumin (IMA), which may serve as biomarkers in maternal blood for pregnancy complications. We evaluate the performance of oxidative stress-associated potential biomarkers for FGR and PE, and their relationship with clinical characteristics.
Methods:
A prospective clinical pilot study was performed in healthy controls and women with pregnancies complicated by severe FGR with or without PE. Blood samples were taken directly after inclusion and analyzed for FT; IMA; soluble FMS-like tyrosine kinase-1 (sFlt-1); placenta growth factor (PlGF); and biomarkers like leptin and soluble receptors for advanced glycation end products (sRAGE). Placentas were examined microscopically. Descriptive statistics and receiver operating characteristics statistics were performed.
Results:
Mothers with both severe FGR and PE had significantly reduced FT levels (p < 0.001) and PlGF levels (p < 0.001), and increased levels of plasma IMA (p < 0.05), sFlt (p < 0.001), leptin (p < 0.05) and sRAGE (p < 0.01) compared to women with FGR only. Systemic FT levels were significantly inversely associated with blood pressure (p < 0.01) and plasma IMA (p < 0.001), leptin (p = 0.01) and sRAGE (p < 0.001). Systemic FT and leptin showed significant discriminative ability to differentiate mothers with both FGR and PE from mothers with uncomplicated pregnancies or pregnancies complicated by FGR only.
Discussion:
There is a significant discriminative capacity of FT, IMA, leptin and sRAGE that harbor potential as biomarkers of pregnancies complicated by combined FGR and PE.
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