BESİNSEL ANTİOKSİDAN BİLEŞENLERİNİN MATERNAL VE FETAL SAĞLIK ÜZERİNE ETKİLERİ

Gebelik döneminde yeterli ve dengeli beslenme maternal ve fetal sağlığı doğrudan etkilemektedir. Bu dönemde makro ve mikro besin ögelerinden gereksinim duyulan miktarda almak önemlidir. Çünkü gebelik döneminde makro ve mikro besin ögeleri yetersizlikleri birçok farklı patolojik durum ile ilişkilidir. Metabolizmada birçok farklı işlevi bulunan mikro besin ögelerinin yer aldığı en önemli sistemlerden birisi savunma sistemi olarak adlandırılan antioksidan sistemdir. Antioksidan sistemin tam ve etkili çalışabilmesi için gerekli besinsel antioksidan bileşenlerinin beslenme programında yeterli miktarda yer alması fetal ve maternal antioksidan durumu etkilemektedir. Serbest radikallere karşı maternal ve fetal savunmayı sağlayan antioksidan sistemin tam ve etkili çalışabilmesi için enzimatik ve enzimatik olmayan antioksidanlara ihtiyaç vardır. Antioksidan sistemde etkili birçok farklı bileşen yer almasına karşın A, C, E vitaminleri ve çinko, bakır, selenyum üzerinde en çok çalışılan besinsel antioksidan bileşenlerdir. Bu antioksidan bileşenler etkilerini farklı mekanizmalar üzerinden gerçekleştirmekle birlikte genel olarak antioksidan enzimlere kofaktör etki göstererek ya da doğrudan vücutta antioksidan bileşenlerin varlığını koruyarak etki göstermektedir. Annenin beslenme düzeni gebelik döneminde hem annenin hem de fetüsün sağlığının korunması ve devam ettirilmesi için oldukça önemlidir. Fetal ve neonatal sağlığın korunması, intrauterin gelişimin sağlanması, fetal-neonatal antioksidan sistemin aktif çalışabilmesi için gebelik döneminde gereksinim duyulan miktarlarda antioksidan etki gösteren besin bileşenlerinden alınmalıdır. Antioksidan sistemin doğru çalışmaması durumunda vücutta artan reaktif oksijen türleri (ROS) ve diğer zararlı bileşikler hücresel hasara sebep olabilmektedir. Ayrıca artan oksidatif stres preeklampsi, intrauterin büyüme yetersizliği (IUGR), diyabet ve diğer üreme sistemi patolojilerine sebep olabilmektedir. Derleme olarak hazırlanan bu makalede besinsel antioksidan kaynaklarının maternal ve fetal sağlığa etkilerine yönelik güncel bilgilerin paylaşılması amaçlanmıştır.

Anahtar Kelimeler:

antioksidan, vitamin, mineral, maternal, fetal

THE EFFECTS OF NUTRITIONAL ANTIOXIDANT COMPONENTS ON MATERNAL AND FETAL HEALTH

Adequate and balanced nutrition during pregnancy directly affects maternal and fetal health. In this period, it is important to take the required amount of macro and micronutrients because inadequacies of macro and micronutrients during pregnancy are associated with many different pathological conditions. One of the most important systems that contain micronutrients which have many different functions in metabolism is the antioxidant system called the defense system. Fetal and maternal antioxidant status affects the nutrient antioxidant components’ ability to work fully and effectively. The antioxidant system that provides maternal and fetal defense against free radicals requires enzymatic and non-enzymatic antioxidants to function fully and effectively. Although many different components are effective in the antioxidant system, vitamins A, C, E and zinc, copper, selenium are the most studied nutritional antioxidant components. Although these antioxidant components perform their effects through different mechanisms, they generally show antioxidant effects by acting as a cofactor effect on antioxidant enzymes or by preserving the presence of antioxidant components directly in the body. Maternal nutrition is very important for maintaining the health of both the mother and the fetus during pregnancy. In order to maintain fetal and neonatal health, to ensure intrauterine development, and to operate the fetal-neonatal antioxidant system actively, the nutrient components showing the antioxidant effect and required during pregnancy should be taken adequately. If the antioxidant system does not work properly, increased reactive oxygen species (ROS) and other harmful compounds in the body can cause cellular damage. In addition, increased oxidative stress may cause preeclampsia, intrauterine growth deficiency (IUGR), diabetes and other reproductive system pathologies. In this article, it is aimed to share current information on the effects of nutritional antioxidant sources on maternal and fetal health.

Keywords:

Antioxidant , Maternal, Fetal, Vitamin, Mineral,

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Lipton LR, Brunst KJ, Kannan S, et al. Associations among prenatal stress, maternal antioxidant intakes in pregnancy, and child temperament at age 30 months. Journal of Developmental Origins of Health and Disease 2017;8(6): 638-648.
Duhig K, Chappell LC, Shennan AH. Oxidative stress in pregnancy and reproduction. Obstetric Medicine 2016;9(3): 113-116.
Agarwal A, Gupta S, Sekhon L, Shah R. Redox considerations in female reproductive function and assisted reproduction: from molecular mechanisms to health implications. Antioxid Redox Signal 2008;10:1375–403.
Luo ZC, Fraser WD, Julien P, Deal CL, Audibert F, Smith GN. Tracing the origins of “fetal origins” of adult diseases: programming by oxidative stress? Med Hypotheses 2006;66: 38–44.
Birben E, Şahiner UM, Sackesen C, Erzurum S, Kalayci O. Oxidative stress and antioxidant defense. World Allergy Organ J 2012; 5: 9-19.
Taravati A, Tohidi F. Comprehensive analysis of oxidative stress markers and antioxidants status in preeclampsia. Taiwanese Journal of Obstetrics and Gynecology 2018;57(6):779–790.
Krishna Mohan S, Venkataramana G. Status of lipid peroxidation, glutathione, ascorbic acid, vitamin E and antioxidant enzymes in patients with pregnancy induced hypertension. Indian J Physiol 2007;51: 284-8.
Valsamakis G, Kanaka-Gantenbein C, Malamitsi-Puchner A, Mastorakos G. Causes of intrauterine growth restriction and the postnatal development of the metabolic syndrome. Ann NY Acad Sci 2006; 1092:138-47.
Iborra A, Palacıo JR, Martinez P. Oxidative stress and autoimmune response in the infertile woman. Chem Immunol Allergy 2005;88: 150–62.
Napoli JL. Physiological insights into all-trans-retinoic acid biosynthesis. Biochim. Biophys 2012;1821: 152–167.
Chien C, Lee Y, Cho HS, et al. Maternal vitamin A deficiency during pregnancy affects vascularized islet development. The Journal of Nutritional Biochemistry 2016;36: 51–59.
Lira LQ, Dimenstein R. Vitamin A and gestational diabetes. Rev Assoc Med Bras 2010;56: 355–359.
Ucci M, Dı Tomo P, Tritschler F, et al. A. Anti-inflammatory Role of Carotenoids in Endothelial Cells Derived from Umbilical Cord of Women Affected by Gestational Diabetes Mellitus. Oxidative Medicine and Cellular Longevity 2019:1–11.
Thorne-Lyman AL, Fawzı WW. Vitamin A and Carotenoids During Pregnancy and Maternal, Neonatal and Infant Health Outcomes: a Systematic Review and Meta-Analysis. Pediatric and Perinatal Epidemiology 2012; 26: 36-54.
Bastos Maia S, Rolland Souza A, Costa Caminha M, et al. Vitamin A and Pregnancy: A Narrative Review Nutrients 2019;11(3): 681.
Huang Y, Zheng S. The effect of vitamin A deficiency during pregnancy on anorectal malformations. J Pediatr Surg 2011;46: 1400–1405.
El-Khashab EK, Hamdy AM, Maher KM, Fouad MA, Abbas GZ. Effect of maternal vitamin A deficiency during pregnancy on neonatal kidney size. J Perinat Med 2013;41: 199–203.
Yusuf H, Subih HS, Obeıdat BS, Sharkas G. Associations between macro and micronutrients and antioxidants intakes with preeclampsia, results from a case-control study in Jordanian pregnant women. Nutrition, Metabolism and Cardiovascular Diseases 2019; 29(5): 458-466.
World Health Organization (WHO). Guideline: Vitamin A Supplementation in Pregnant Women; World Health Organization 2011.
Poston L, Briley AL, Seed PT, Kelly FJ, Shennan AH. Vitamins in Preeclampsia (VIP) Trial Consortium. Vitamin C and vitamin E in pregnant women at risk for preeclampsia (VIP trial): randomised placebo controlled trial. Lancet 2006; 367:1145-54.
Mezouar D, Merzouk H, Merzouk AS, Merzouk SA, Belarbi B, Narce M. In vitro effects of vitamins C and E, n-3 and n-6 PUFA and n-9 MUFA on placental cell function and redox status in type 1 diabetic pregnant women. Placenta 2016;42:114-121.
Cardoso PM, Surve S. The Effect of Vitamin E and Vitamin C on the Prevention of Preeclampsia and Newborn Outcome: A Case Control Study. The Journal of Obstetrics and Gynecology of India 2016; 66(1):271–278.
Roberts JM, Myatt L, Spong CY, Thom EA, Hauth JC, Leveno KJ. Vitamins C and E to prevent complications of pregnancy-associated hypertension. N Engl J Med 2010;362:1282-91.
Mujavar JR, Patel SS. Circulating biomarkers of oxidative stress in preeclampsia and efficacy of antioxidant Vitamin C supp. Research Journal of Pharmaceutical, Biological and Chemical Sciences 2016;7(1):1498-1506.
Negi R, Pande D, Karkı K, Kumar A, Khanna RS, Khanna HD. Association of oxidative DNA damage, protein oxidation and antioxidant function with oxidative stress induced cellular injury in preeclamptic/eclamptic mothers during fetal circulation. Chemico-Biological Interactions 2014;208:77–83.
Afzhal-Ahmed I, Mann CE, Shennan AH, Poston L, Naftalin RI. Preeclampsia inactivates glucose-6-phopshatedehydrogenase and impairs the redox status of erythrocytes and fetal endothelial cells. Free Radic Biol Med 2007;42:1781-90.
Tenório MB, Ferreira RC, Moura FA, Bueno NB, Goulart MOF, Oliveira ACM. Oral antioxidant therapy for prevention and treatment of preeclampsia: Meta-analysis of randomized controlled trials. Nutrition, Metabolism and Cardiovascular Diseases 2018;28(9):865–876.
Rumbold A, Ota E, Hori H, Miyazaki C, Crowther CA. Vitamin E supplementation in pregnancy. Cochrane Database of Systematic Reviews 2015;9: CD004069.
Rumbold A, Ota E, Nagata C, Shahrook S, Crowther CA. Vitamin C supplementation in pregnancy. Cochrane Database of Systematic Reviews 2015;(9):CD004072.
Johnston PC, Mccance DR, Holmes VA, Young IS, Mcgınty A. Placental antioxidant enzyme status and lipid peroxidation in pregnant women with type 1 diabetes: The effect of vitamin C and E supplementation. Journal of Diabetes and Its Complications 2016;30(1):109–114.
Gadhok AK, Sharma TK, Sinha M, et al. Natural antioxidant vitamins status in pregnancies complicated with intrauterine growth restriction. Clinical Laboratory 2017;63(5):941-945.
Rebecca L, Jessica W, Grieger A, Bianco-Mıotto T, Claire T. Association between Maternal Zinc Status, Dietary Zinc Intake and Pregnancy Complications: A Systematic Review. Nutrients 2016;8: 641-645.
Fard FE, Mirghafourvand M, Mohammad-Alizade Charandabis S, Farshbaf-Khalli A, Javadzadeh Y, Asgharian H. Effects of zinc and magnesium supplements on postpartum depression and anxiety: A randomized controlled clinical trial. Women & Health 2017;57(9):1115–1128.
Jamilian M, Mirhosseini N, Eslahi M, et al. The effects of magnesium-zinc-calcium vitamin D co-supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. BMC Pregnancy and Childbirth 2019;19(1):107. Bédard A, Northstone K, Holloway JW, Henderson AI, Shaheen SO. Maternal dietary antioxidant intake in pregnancy and childhood respiratory and atopic outcomes: birth cohort study. European Respiratory Journal 2018;1800507.
Terrin G, Berni Canani R, Di Chiara M, et al. Zinc in Early Life: A Key Element in the Fetus and Preterm Neonate. Nutrients 2015;7(12): 10427-10446.
Wieringa FT, Dijkhuizen MA, Van Der Meer JWM. Maternal micronutrient supplementation with zinc and β-carotene affects morbidity and immune function of infants during the first 6 months of life. European Journal of Clinical Nutrition 2010; 64(10):1072-1079.
Cim N, Tolunay HE, Boza B, et al. Is there any associaton between fetal nervous system anomalies and heavy metal-trace element levels amnionic fluid? Clinical and Experimental Obstetrics and Gynecology 2018;45(4): 555-557.
Abbas AM. Evaluating the effects of copper supplement during pregnancy on premature rupture of membranes and pregnancy outcome: some statistical issues. Journal of Maternal Fetal and Neonatal Medicine 2019;32(16):2777.
O’brien KO, Zavalta N, Caulfield LE, Wen J, Abrams SA. Prenatal iron supplements impair zinc absorption in pregnant Peruvian women. J Nutr 2000;130: 2251-2255.
Demir N, Basaranoglu M, Huyut Z, et al. The relationship between mother and infant plasma trace element and heavy metal levels and the risk of neural tube defect in infants. J. Matern.-Fetal Neonatal Med 2019:1–8.
West C, Dunstan J, Mccarthy S, et al. Association between Maternal Antioxidant Intakes in Pregnancy and Infant Allergic Outcomes Nutrients 2012;4(11):1747-1758.
Escobar GM, Obregón MJ, Rey FE. Maternal thyroid hormones early in pregnancy and fetal brain development. Best Pract Res Clin Endocrinol Metab 2004;18(2): 225–48.
Mesdaghinia E, Rahavi A, Bahmani F, Sharıfı N, Asemi Z. Clinical and Metabolic Response to Selenium Supplementation in Pregnant Women at Risk for Intrauterıne Growth Restriction: Randomized Double Blind, Placebo-Controlled Trial. Biological Trace Element Research 2016;178 (1):14-21.
Wang Z, Wang C, Qıu J, et al. The Association between Dietary Vitamin C/E and Gestational Hypertensive Disorder: A Case Control Study. Journal of Nutritional Science and Vitaminology 2018;64(6): 454-465.
Lewandowska M, Sajdak S, Lubıńskı J. Serum Selenium Level in Early Healthy Pregnancy as a Risk Marker of Pregnancy Induced Hypertension. Nutrients 2019;11(5): 1028.
Bergamaschi DP, Mariath AB, Abbade JF, Grillo LP, Diniz CS, Hinnig PF. Selenium supplementation during pregnancy for improving maternal and newborn outcomes. Cochrane Database of Systematic Reviews 2012;3: CD009673 .