During pregnancy, oxidative stress has been implicated in the pathophysiology of preeclampsia and preterm
birth leading to poor birth outcome. Hyperhomocysteinemia caused as a consequence of altered micronutrients like folic
acid and vitamin B12 is associated with increased production of reactive oxygen species that generate oxidative stress.
These micronutrients are important determinants of methyl donor, s-adenosyl methionine while phospholipids are important
methyl acceptors in the one-carbon metabolic cycle. A series of our studies in women during pregnancy have demonstrated
altered levels of these micronutrients and the negative association of docosahexaenoic acid with homocysteine.
Various strategies to counteract oxidative stress during pregnancy such as antioxidant therapy have been examined and
found to be inconsistent. In this review, we focus on the role of oxidative stress in pregnancy and discuss the possibility of
ameliorating it through modulation of maternal micronutrients and omega 3 fatty acids especially docosahexaenoic acid.
We propose for the first time that manipulation of one-carbon metabolism by maternal diet could be a potential mechanism
to counteract oxidative stress through homocysteine lowering effects and help in reducing the risk for adverse pregnancy
Keywords: Docosahexaenoic acid, folic acid, homocysteine, one carbon metabolism, preeclampsia, preterm birth, reactive
oxygen species, vitamin B12.
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