SERUM LEVELS OF VITAMIN C, BETA-CAROTENE AND MALONYL DIALDEHYDE IN PRE-ECLAMPTIC AND HEALTHY PREGNANT WOMEN IN ENUGU, SOUTH- EAST NIGERIA.
Background: Pre-eclampsia is the most common medical complication of pregnancy causing significant morbidity and mortality to the mother and fetus yet the patho-physiology of this disease is poorly understood. The imbalance between free radicals and antioxidant vitamins that may lead to endothelial dysfunction appear to be a central feature in the pathogenesis of this disease. However, there is paucity of information regarding the serum level of antioxidant vitamins and free radical of pre-eclamptic Nigerian women.
Aims/Objective: The study aimed at determining the serum level of vitamin C, beta carotenes and malonyl dialdehyde in pre-eclamptic women in Enugu, South-Eastern Nigeria.
Study Design: This was a case control study of pre-eclamptic and healthy non toxaemic pregnant women in Enugu, south east Nigeria.
Materials and methods: The study was carried out at the University of Nigeria, Teaching Hospital Ituku-Ozalla Enugu, Enugu State University of Science and Technology Teaching Hospital Parklane Enugu and Annunciation specialist hospital Emene, Enugu. Eighty two pre-eclamptic and eighty two healthy pregnant women matched for age, gestational age and parity were recruited within one year and their serum samples analyzed for vitamins C, beta carotene and malonyl dialdehyde spectrophotometrically
Data collated was coded, entered and analyzed using Statistical Package for Social Science version 22.0. Descriptive statistics which includes frequency and percentages were used to summarize categorical variables while means and standard deviations were obtained for continuous variables. Associations between categorical variables were done using Chi-square and logistic regression while means of continuous variables were compared using students t-test. P-value of less than 0.05 was considered significant. Data were presented in tables and chart
Results: The mean age of the subjects was 30.29 ± 0.64. Systolic and diastolic blood pressures were significantly higher in the subjects (P < 0.001) The mean level of vitamin C, beta-carotene, and MDA levels among the subjects were 19.54 ± 0.48, 6.52 ± 1.69 and 1.77 ± 0.70 respectively and that of the controls were 144.06 ± 1.66, 10.83 ± 1.61 and 1.46 ± 0.64 respectively. Vitamin C and beta-carotene levels were very significantly lower in the subjects when compared to the controls (P < 0.001). However, malonyl dialdehyde was significantly lower in the controls (t = 2.889, P = 0.004). Patients with low level of vitamin C were about 11 times more likely to have pre-eclampsia (P < 0.001, OR = 10.667, 95% C.I = 5.152 – 22.083). Patients with low level of beta-carotene were 13 times more likely to have pre-eclampsia (P < 0.001, OR = 13.263, 95% C.I = 6.262 – 28.093). Patients with high level of malonyl dialdehyde were 2 times more likely to have pre-eclampsia (P = 0.016, OR = 2.474, 95% C.I = 1.182 – 5.179). Low level of vitamin C is more significantly associated with severe pre-eclampsia than mild pre-eclampsia (Fisher’s exact test = 0.034).
Low mean serum levels of vitamin C and beta-carotene and high mean serum level of malonyl dialdehyde are associated with the development of pre-eclampsia. Low serum level of vitamin C is more significantly associated with severity of pre-eclampsia. Estimating the levels of vitamin C, beta-carotene and malonyl dialdehyde may have a predictive role in assessment of the extent of endothelial damage in pre-eclampsia. This suggests that antioxidant vitamins supplementation in pregnancy may be beneficial in the management of pre-eclampsia in our environment. This calls for further researches on the possible effects of early antioxidant supplementation in prevention or management of pre-eclamptic women in our environment