Terapia antioxidante oral para prevenção e tratamento da pré-eclâmpsia: metanálise de ensaios clínicos aleatórios

Abstract

Hypertensive syndromes that affect pregnant women entail high rates of morbidity and mortality, both maternal and fetal. Among them, preeclampsia (PE), known as the theories disease, is clinically characterized by systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg associated with proteinuria (> 300 mg / 24 hours), after the 20th week gestation. Although its etiology has not yet been well established, it is known that the pathophysiology of the disease is strongly influenced by the placenta, where placentation changes associated with an increase in placental oxidative stress occur in the initial gestation process. There is also a generalized inflammatory process, as well as the presence of progressive vascular endothelial damage, leading to this organ dysfunction. Thus, these processes can lead to adverse pregnancy outcomes such as intrauterine growth restriction, placental rupture, preterm delivery, small newborns for gestational age, fetal death, among others. On the other hand, there is no consensus in the literature on the best strategies for prevention and treatment of the disease, especially for nutrition. However, supplementation with antioxidants has been considered in order to minimize the damage caused by oxidative stress present in pathophysiology. In view of the above, this study aims to determine if oral antioxidant therapies, of various types and doses, are able to prevent or treat women with PE and the associated adverse outcomes. In addition, these findings may help clinical and nutritional behaviors, as well as provide subsidies for the formulation of health policies in this scope, and consequently, improve maternal and fetal health in the short and long term.