O papel das terapias antioxidantes orais para prevenção e tratamento da pré-eclâmpsia: uma meta-análise atualizada

Abstract

Pre-eclampsia (PE) is considered one of the main causes of maternal and fetal morbidity and mortality worldwide and, despite its importance for maternal and fetal health, there is still no consensus in the literature about the best clinical and nutritional strategies for its prevention and/or treatment. However, even in the face of controversy, supplementation with antioxidants has been considered to attenuate damage caused by oxidative stress involved in the pathophysiology of the disease. This dissertation initially presents a literature review chapter that discusses the etiological aspects and the involvement of oxidative stress in the development of PE, as well as the therapeutic role of antioxidants on the disease. Next, an original article is presented that presents an updated meta-analysis of oral antioxidant therapies with the aim of determining whether they are effective in preventing and/or treating PE.This is a meta-analysis in which the PubMed, Cochrane Central Register of Controlled Trials, LILACS (Latin American and Caribbean Literature in Health Sciences), Web of Science and ScienceDirect databases were searched, and in the studies considered eligible, based on the inclusion criteria, data extraction and risk of bias analysis were performed. For the statistical analyses, the calculation of the relative risk (RR) for each outcome, between the groups, the Mantel-Haenszel method for attributing the weights of each study was used and the calculations were based on a random effects model, adopting a α value=0.05. To assess heterogeneity, the Cochran Q test was used and inconsistency was tested using I² statistics. A p<0.1 was adopted for the Cochran's Q test when heterogeneity was considered important. Significant results in favor of the intervention on the outcome of incidence of PE were identified in prevention studies (RR: 0.86, 95% Confidence Interval: [0.75, 0.99], p = 0.03; I ² = 44%, p = 0.02) and in the results associated with treatment studies, there was a significant result in favor of the intervention on the outcome of intrauterine growth restriction.