Aim To investigate biosynthesis in nitric oxide (NO) during normal pregnancy and in pregnancies complicated by preeclampsia. Methods This prospective cross-sectional study included 80 patients hospitalized at the Department of Women's Health, Neonatology and Perinatology Cantonal Hospital in Zenica. Serum NO concentration in 20 non-pregnant women, 40 healthy pregnant women and 20 pregnant women with preeclampsia aged 17-40 years were measured. The group of healthy pregnant women were divided into 4 subgroups by gestational age. For each woman with preeclampsia, a healthy pregnant control was matched for age, parity and gestational age. Serum NO concentrations were determined after reduction of nitrates to nitrites using the Griess reaction. Results NO concentrations during second trimester of pregnancy (37.2±1.7µM; p<0.05) and third trimester of pregnancy (40.9±2.8μM; p<0.05) were significantly higher in healthy pregnant women than in non-pregnant women (29.3±1.7μM). Serum NO concentrations were lower in preeclamptic women (30.7±1.8μM) compared to matched healthy pregnant women of the third and the late third trimester (35.1±2.2μM), without significant differences. Mean NO concentrations in pre-eclamptic women was positively correlated with systolic blood pressure (r=0.58; p<0.01), diastolic blood pressure (r=0.45; p<0.05), creatinine clearance (r=0.48; p<0.05), uric acid (r=0.49; p<0.05), and negatively correlated with platelet count (r=-0.57; p<0.05). Conclusion NO production was increased with gestational age during normal pregnancy and slightly decreased in preeclampsia suggesting that NO may modulate the cardiovascular changes during normal pregnancy and pregnancy complicated by preeclampsia.
Wedel J, Mandala M, Barron C, Bernstein I, Osol G. Mechanisms underlying maternal venous adaptation in pregnancy. Reprod Sci. 2009;596–604.
2.
Leo C, Jelinic M, Ng H, Marshall S, Novak J, Tare M, et al. Vascular actions of relaxin: nitric oxide and beyond. Br J Pharmacol. 2017;1002–14.
3.
Valdes G, Kaufmann P, Corthorn J, Erices R, Brosnihan K, Joyner-Grantham J. Vasodilator factors in the systemic and local adaptations to pregnancy. Reprod Biol Endocrinol. 2009;79.
4.
Poniedziałek-Czajkowska E, Marciniak B, Kimber-Trojnar Z, Leszczyńska-Gorzelak B, Oleszczuk J. Nitric oxide in normal and preeclamptic pregnancy. Curr Pharm Biotechnol. 2011;743–9.
5.
Choi J, Im M, Pai S. Nitric oxide production increases during normal pregnancy and decreases in preeclampsia. Ann Clin Lab Sci. 2002;257–63.
6.
Shaamash A, Elsnosy E, Makhlouf A, Zakhari M, Ibrahim O. EL-dien HM. Maternal and fetal serum nitric oxide (NO) concentrations in normal pregnancy, pre-eclampsia and eclampsia. Int J Gynaecol Obstet. 2000;207–14.
7.
Hata T, Hashimoto M, Kanenishi K, Akiyama M, Yanagihara T, Masumura S. Maternal circulation nitrite levels are decreased in both normal normotensive pregnancies and pregnancies with preeclampsia. Gynecol Obstet Invest. 1999;93–7.
8.
Brown M, Tibben E, Zammit V, Cario G, Carlton M. Nitric oxide excretion in normal and hypertensive pregnancies. Hypertens Pregnancy. 1995;319–26.
9.
Smarason A, Allman K, Young D, Redman C. Elevated levels of serum nitrate, a stable end product of nitric oxide, in women with pre-eclampsia. Br J Obstet Gynaecol. 1997;538–43.
10.
Carty D, Delles C, Dominiczak A. Preeclampsia and future maternal health. J Hypertens. 2010;1349–55.
11.
Make every mother and child count. The world health report. Geneva. 2005;
12.
Poon L, Kametas N, Chelemen T, Leal A, Nicolaides K. Maternal risk factors for hypertensive disorders in pregnancy: a multivariate approach. J Hum Hypertens. 2010;104–10.
13.
Su J. Vascular endothelial dysfunction and pharmacological treatment. World J Cardiol. 2015;719–41.
14.
Matsubara K, Matsubara Y, Hyodo S, Katayama T, Ito M. Role of nitric oxide and reactive oxygen species in the pathogenesis of preeclampsia. J Obstet Gynaecol Res. 2010;239–47.
15.
Zeng Y, Li M, Chen, Homocysteine W. endothelin-1 and nitric oxide in patients with hypertensive disorders complicating pregnancy. Int J Clin Exp Pathol. 2015;15275–9.
16.
Davidge S, Stranko C, Roberts J. Urine but not plasma nitric oxide metabolites are decreased in women with preeclampsia. Am J Obstet Gynecol. 1996;1008–13.
17.
Cameron I, Van Papendorf C, Palmer R, Smith S, Moncada S. Relationship between nitric oxide synthesis and increase in systolic blood pressure in women with hypertension in pregnancy. Hypertens Pregnancy. 1993;85–92.
18.
Filho A, B, Da Costa P, Ogando B, Vieira P, M, et al. Poli-de-Figueiredo CE. Serum nitrate and NOx levels in preeclampsia are higher than in normal pregnancy. Hypertens Pregnancy. 2016;226–33.
19.
Report on high blood pressure in pregnancy. Am J Obstet Gynecol. 2000;1–22.
20.
Green L, Wagner D, Glogowski J, Skipper P, Wishnok J, Tannenbaum S. Analysis of nitrate, nitrite and 15N nitrate in biological fluids. Anal Biochem. 1982;131–8.
21.
Bryan N, Grisham M. Methods to detect nitric oxide and its metabolites in biological samples. Free Radic Biol Med. 2007;645–57.
22.
Choi J, Pai S, Kim S, Ito M, Park C, Cha Y. Iron deficiency anemia increases nitric oxide production in healthy adolescents. Ann Hematol. 2002;1–6.
23.
Ni Z, Morcos S, Vaziri N. Up-regulation of renal and vascular nitric oxide synthase in iron deficiency anemia. Kidney Int. 1997;195–201.
24.
Mabbott N, Sternberg J. Bone marrow nitric oxide production and development of anemia in Trypanosoma brucei-infected mice. Infect Immun. 1995;1563–6.
25.
Lyall F, Young A, Greer I. Nitric oxide concentrations are increased in the fetoplacental circulation in preeclampsia. Am J Obstet Gynecol. 1995;714–8.
26.
Brennecke S, Gude N, Iulio D, King J, R. Reduction of placental nitric oxide synthase activity in pre-eclampsia. Clin Sci. 1997;51–5.
27.
Owusu B, Stapley R, Honavar J, Patel R. Effects of erythrocyte aging on nitric oxide and nitrite metabolism. Antioxid Redox Signal. 2013;1198–208.
28.
Mackenzie I, Ekangaki A, Young D, Garrard C. Effect of renal function on serum nitrogen oxide concentrations. Clin Chem. 1996;440–4.
29.
Paşaoğlu H, Bulduk G, Oğüş E, Paşaoğlu A, Onalan G. Nitric oxide, lipid peroxides, and uric acid levels in pre-eclampsia and eclampsia. Tohoku J Exp Med. 2004;87–92.
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