Antioxidants as a Novel Approach in the Management of Early-onset Fetal Growth Restriction with Oligohydramnios: A Case Report and Review of Literature
Citation Information :
Sarbhai V, Mittal S, Prasad K. Antioxidants as a Novel Approach in the Management of Early-onset Fetal Growth Restriction with Oligohydramnios: A Case Report and Review of Literature. Int J Infertil Fetal Med 2024; 15 (3):164-167.
Fetal growth restriction (FGR) is characterized by the failure of the developing fetus to attain its maximum growth potential as influenced by its genetic makeup. Severe early-onset FGR occurs in only 0.4% of pregnancies, with a grim prognosis for affected individuals. While the fetal genome plays a crucial role in determining growth potential in the womb, emerging evidence highlights the significant impact of the intrauterine environment on fetal development. In this case, we present an instance where administering the antioxidant glutathione and supplementing with essential amino acids to the mother successfully reversed the halted growth and severe oligohydramnios in an early-onset growth-restricted fetus.
Gordijn SJ, Beune IM, Thilaganathan B, et al. Consensus definition of fetal growth restriction: a Delphi procedure. Ultrasound Obstet Gynecol 2016;48:333–339. DOI: 10.1002/uog.15884
Ganzevoort W, Alfirevic Z, von Dadelszen P, et al. STRIDER: Sildenafil Therapy In Dismal prognosis Early-onset intrauterine growth Restriction—a protocol for a systematic review with individual participant data and aggregate data meta-analysis and trial sequential analysis. Syst Rev 2014;3:23. DOI: 10.1186/2046-4053-3-23
Von Dadelszen P, Dwinnell S, Magee LA, et al. Sildenafil citrate therapy for severe early-onset intrauterine growth restriction. BJOG 2011;118:624–628. DOI: 10.1111/j.1471-0528.2010.02879.x
Barker DJ, Clark PM. Fetal undernutrition and disease in later life. Rev Reprod 1997;2:105–112. DOI: 10.1530/ror.0.0020105
Hsu CN, Tain YL. Amino acids and developmental origins of hypertension. Nutrients 2020;12(6):1763. DOI: 10.3390/nu12061763
Griffiths OW. Biologic and pharmacologic regulation of mammalian glutathione synthesis. Free Radic Biol Med 1999;27:922–935. DOI: 10.1016/s0891-5849(99)00176-8
Obolenskaya MY, Teplyuk NM, Divi RL, et al. Human placental glutathione S-transferase activity and polycyclic aromatic hydrocarbon DNA adducts as biomarkers for environmental oxidative stress in placentas from pregnant women living in radioactivity-and chemically-polluted regions. Toxicol Lett 2010;196(2):80–86. DOI: 10.1016/j.toxlet.2010.03.1115
Aebi S, Assereto R, Lauterburg BH. High-dose intravenous glutathione in man. Pharmacokinetics and effects on cyst(e)ine in plasma and urine. Eur J Clin Invest 1991;21(1):103–110. DOI: 10.1111/j.1365-2362.1991.tb01366.x
Flynn NE, Meininger CJ, Haynes TE, et al. The metabolic basis of arginine nutrition and pharmacotherapy. Biomed Pharmacother 2002;56:427–438. DOI: 10.1016/s0753-3322(02)00273-1
Ishida M, Hiramatsu Y, Masuyama H, et al. Inhibition of placental ornithine decarboxylase by DL–difluoro-methyl ornithine causes fetal growth restriction in rat. Life Sci 2002;70:1395–1405. DOI: 10.1016/s0024-3205(01)01510-7
Buonocore G, Perrone S, Tataranno ML. Oxygen toxicity: chemistry and biology of reactive oxygen species. Semin Fetal Neonatal Med 2010;15:186–190. DOI: 10.1016/j.siny.2010.04.003
Lewen A, Matz P, Chan PH. Free radical pathways in CNS injury. J Neurotrauma 2000;17:871–890. DOI: 10.1089/neu.2000.17.871
Miller SL, Wallace EM, Walker DW. Antioxidant therapy: a potential role in perinatal medicine. Neuroendocrinology 2012;96:13–23 DOI: 10.1159/000336378
Shallie PD, Sulaiman AI, Oladejo MK, et al. Early glutathione intervention educed positive correlation between VGLUT1 expression and spatial memory in the Nω-nitro-L-arginine methyl rat model of IUGR. IBRO Neurosci Rep 2021;10:136–141. DOI: 10.1016/j.ibneur.2021.02.003
Peterson JD, Herzenberg LA, Vasquez K, et al. Glutathione in antigen presenting cells modulates TH 1 versus TH 2 response patterns. Proc Natl Acad Sci USA 1998;17:3071–3076. DOI: 10.1073/pnas.95.6.3071
Vosatka RJ, Hassoun PM, Harvey-Wilkes KB. Dietary L-arginine prevents fetal growth restriction in rats. Am J Obstet Gynecol 1998;178:242–246. DOI: 10.1016/s0002-9378(98)80007-0
Terstappen F, Tol AJ, Gremmels H, et al. Prenatal amino acid supplementation to improve fetal growth: a systematic review and meta-analysis. Nutrients 2020;12(9):2535. DOI: 10.3390/nu12092535
Porter AC, Gumina DL, Armstrong M, et al. Maternal amino acid profiles to distinguish constitutionally small versus growth-restricted fetuses defined by Doppler ultrasound: a pilot study. Am J Perinatol 2020;37(11):1084–1093. DOI: 10.1055/s-0040-1701504