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Abstract：
BACKGROUND: Placental insufficiency is an important mechanism underlying early-onset fetal growth restriction (eoFGR). Reduced placental function causes impaired metabolic and gaseous exchange. This unfavorable placental environment is among other processes characterized by increased oxidative stress. Systemic free thiols (FT) are known for their reactive oxygen species scavenging capacity, and higher plasma levels of FT are associated with a better outcome in a multitude of ischemic and inflammatory diseases. We aimed to investigate the relationships between systemic FT levels and maternal and perinatal clinical characteristics and outcomes.
METHODS: In a post hoc analysis of the Dutch Strider study, a cohort of women with eoFGR, we investigated the association between the maternal redox status (FT) levels at study inclusion, placental biomarkers, and maternal and neonatal outcomes in 108 patients.
RESULTS: FT were significantly lower in pregnancies complicated with eoFGR with concurrent maternal hypertensive disorders (pregnancy-induced hypertension; ρ = -0.281 p = 0.004, pre-eclampsia; ρ = -0.505 p = 0.000). In addition, lower FT levels were significantly associated with higher systolic (ρ = -0.348 p = 0.001) and diastolic blood pressure (ρ = -0.266 p = 0.014), but not with the severity of eoFGR. FT levels were inversely associated with sFlt (ρ = -0.366, p < 0.001). A strong relation between systemic FT levels and PlGF levels was observed in women with pre-eclampsia at delivery (ρ = 0.452, p = 0.002), which was not found in women without hypertensive disorders (ρ = 0.008, p = 0.958).
CONCLUSIONS: In women with pregnancies complicated with eoFGR, FT levels reflect the severity of maternal disease related to the underlying placental insufficiency rather than the severity of the placental dysfunction as reflected in eoFGR or perinatal outcomes.
METHODS: In a post hoc analysis of the Dutch Strider study, a cohort of women with eoFGR, we investigated the association between the maternal redox status (FT) levels at study inclusion, placental biomarkers, and maternal and neonatal outcomes in 108 patients.
RESULTS: FT were significantly lower in pregnancies complicated with eoFGR with concurrent maternal hypertensive disorders (pregnancy-induced hypertension; ρ = -0.281 p = 0.004, pre-eclampsia; ρ = -0.505 p = 0.000). In addition, lower FT levels were significantly associated with higher systolic (ρ = -0.348 p = 0.001) and diastolic blood pressure (ρ = -0.266 p = 0.014), but not with the severity of eoFGR. FT levels were inversely associated with sFlt (ρ = -0.366, p < 0.001). A strong relation between systemic FT levels and PlGF levels was observed in women with pre-eclampsia at delivery (ρ = 0.452, p = 0.002), which was not found in women without hypertensive disorders (ρ = 0.008, p = 0.958).
CONCLUSIONS: In women with pregnancies complicated with eoFGR, FT levels reflect the severity of maternal disease related to the underlying placental insufficiency rather than the severity of the placental dysfunction as reflected in eoFGR or perinatal outcomes.
摘要：
背景：胎盘功能不全是早发性胎儿生长受限（eoFGR）的重要机制。胎盘功能降低导致代谢和气体交换受损。这种不利的胎盘环境是以增加的氧化应激为特征的其他过程。系统性游离硫醇（FT）以其活性氧清除能力而闻名，在许多缺血性和炎性疾病中,较高的血浆FT水平与较好的结果相关。我们旨在调查全身FT水平与孕产妇和围产期临床特征和结局之间的关系。
方法：在对荷兰Strider研究的事后分析中，一群患有eoFGR的女性，我们调查了纳入研究时母体氧化还原状态（FT）水平之间的关联，胎盘生物标志物，108例患者的母婴结局。
结果：在妊娠合并eoFGR并并发母体高血压疾病（妊娠高血压；ρ=-0.281p=0.004，先兆子痫；ρ=-0.505p=0.000）的妊娠中，FT显着降低。此外,较低的FT水平与较高的收缩压（ρ=-0.348p=0.001）和舒张压（ρ=-0.266p=0.014）显着相关，但不是eoFGR的严重性。FT水平与sFlt呈负相关(ρ=-0.366,p<0.001)。在分娩时患有先兆子痫的女性中观察到全身FT水平与PlGF水平之间存在很强的关系（ρ=0.452，p=0.002），在没有高血压疾病的女性中未发现（ρ=0.008，p=0.958）。
结论：在妊娠合并eoFGR的妇女中，FT水平反映了与潜在胎盘功能不全相关的母体疾病的严重程度，而不是反映在eoFGR或围产期结局中的胎盘功能障碍的严重程度。
方法：在对荷兰Strider研究的事后分析中，一群患有eoFGR的女性，我们调查了纳入研究时母体氧化还原状态（FT）水平之间的关联，胎盘生物标志物，108例患者的母婴结局。
结果：在妊娠合并eoFGR并并发母体高血压疾病（妊娠高血压；ρ=-0.281p=0.004，先兆子痫；ρ=-0.505p=0.000）的妊娠中，FT显着降低。此外,较低的FT水平与较高的收缩压（ρ=-0.348p=0.001）和舒张压（ρ=-0.266p=0.014）显着相关，但不是eoFGR的严重性。FT水平与sFlt呈负相关(ρ=-0.366,p<0.001)。在分娩时患有先兆子痫的女性中观察到全身FT水平与PlGF水平之间存在很强的关系（ρ=0.452，p=0.002），在没有高血压疾病的女性中未发现（ρ=0.008，p=0.958）。
结论：在妊娠合并eoFGR的妇女中，FT水平反映了与潜在胎盘功能不全相关的母体疾病的严重程度，而不是反映在eoFGR或围产期结局中的胎盘功能障碍的严重程度。
