Associação entre diagnóstico pré-natal de restrição do crescimento fetal, pequeno para idade gestacional e radicais livres

Abstract

Introduction: Small for gestational age (SGA) fetuses are found in 10% of pregnancies. It is crucial to differentiate between constitutional SGA and fetal growth restriction (FGR). Pregnancies affected by FGR have a higher incidence of adverse peripartum events. However, there are still few studies evaluating the relationship between Doppler findings used for diagnosing and managing pregnancies with FGR and markers of free radicals and oxidative stress. Objectives: To assess the profile of free radicals immediately postpartum in blood samples collected from maternal and umbilical cord blood, and their relationship with the antepartum diagnosis of FGR/SGA. Methodology: A prospective observational case-control study was conducted with pregnant women from the Fetal Medicine Service of HUSM, with a prenatal diagnosis of FGR and SGA, from October 2021 to September 2023, with prior approval from the Research Ethics Committee and Certificate of Presentation for Ethical Appreciation number 50360621.3.0000.5346. Results: A total of 52 cases were collected, of which 32 were FGR and 20 were SGA, plus 31 controls, totaling a sample of 83 patients from October 2021 to September 2023. Higher levels of TBARS (thiobarbituric acid reactive substances) were identified in both neonatal and maternal erythrocytes in the FGR and SGA samples compared to the control group, with values of 0.0014 and 0.0045, respectively. The FGR sample also showed increased levels of TBARS in maternal and neonatal erythrocytes compared to the control group. Additionally, there was a difference when comparing the SGA and FGR groups, showing higher levels of TBARS in maternal erythrocytes in the RCF group. Conclusion: This study found an association between the diagnosis of FGR and SGA and the TBARS erythrocyte profile in both maternal and neonatal samples, as well as similar associations when comparing the FGR group with the controls. Further studies are needed to properly determine the relationship between free radical tests and oxidative stress in populations diagnosed with SGA and FGR, particularly by including Doppler flowmetry criteria as variables to be considered.