• Sajda A. Al-Rubai Depart. of Gyne. and Obstet., College of Medicine, University of Basra, Iraq
  • Jamal Abdul-Barry Depart. of Biochemistry, College of Medicine, University of Basra, Iraq
  • Qutaiba A. Qasim Depart. of Pharmaceutics, College of Pharmacy, University of Basra, Iraq


Recurrent abortion, lipid peroxidation, oxidative stress, antioxidant, trace elements


Objective: To evaluate the association of oxidative stress and impaired antioxidant defense system with the occurrence of recurrent spontaneous abortion (RSA) . Study design : Case –control study consisting of 100 pregnant women with a history of RSA (study group) and 100 healthy pregnant women (control group) , their age ranging (15-45yr.) and both groups are classified into many subgroups according to maternal age , gestational age , parity and number of previous abortions . Fasting blood samples were collected and tested for measurement of serum vitamin C , vitamin E , albumin , oxidative stress biomarker malondialdehyde (MDA) and some essential trace elements (zinc and copper) by using spectrophotometric methods .Student t-test , chi-square and correlation analysis were used for statistical analysis . Results : Serum level of vitamin C , vitamin E , Cu and  Zn were significantly lower (p<0.05) and serum level of MDA was significantly higher (p<0.05) in study group as compared with control group  but no significant difference of serum albumin  (p>0.05) between the two studied groups .Also no significant differences (p>0.05) of all measured biochemical parameters among different age , gestational age, parity and no. of abortions subgroups of patients (study group) except serum albumin, Zinc and Cu/Zn ratio were significantly changed in the last parity subgroup (>P5) as compared with (P1) for albumin level and with other parity subgroups of the same study group for Zinc and Cu/Zn ratio . While there was a significant increase (P<0.05) of MDA level in the (≥7 abortions) as compared with other no. of abortions subgroups of the study group .            The linear regression analysis demonstrated a significant ( r=0.61 , 0.85 , 0.3 , 0.73 , 0.47 , p<0.05) negative correlation for vit.C , vit. E , Zn , Cu and Cu/Zn ratio respectively and significant ( r= 0.83 , p<0.05 ) positive correlation for MDA values with no. of previous abortions of study group . Also there is a significant ( r= 0.18 , 0.19 , 0.25 , 0.2 , p<0.05 ) negative correlation for vit.C , vit.E , Cu and Cu/Zn ratio respectively and significant ( r= 0.2 , p<0.05 ) positive correlation for MDA values with the age of pregnant females of both control and study groups . while there is a significant positive correlation (r=0.16, 0.18, 0.19 , p<0.05) of  serum vit.C , vit.E and Zn respectively and a significant negative correlation (r=0.17, p<0.05 ) of serum MDA with parity in both control and study groups . Conclusions : Our data demonstrate that elevation of lipid peroxides (MDA) together with impaired antioxidant defense and status of trace elements and the presence of possible interrelationship between those parameters may be related at least partly to the pathogenesis of RSA .


Raj Rai , recurrent miscarriage , Dewhursts textbook of gynaecology and obstetrics 2007 ; 7th edition : 100-105 .

Stirrat G , Recurrent miscarriage. Lancet , 1990; 336:673–675 .

Clifford K, Watson H, Grajewaski BA, An informative protocol for the investigation of recurrent miscarriage, Hum. Reprod. 1994; 9:1328-1332.

Kokawa K, Shikone T and Nakano R , Apoptosis in human chorionic villi and decidua during normal embryonic development and spontaneous abortion in the first trimester. Placenta (1998) ; 19:21–26.

Hempstock J, Jauniaux E, Greenwold N and Burton GJ , The contribution of placental oxidative stress to early pregnancy failure. Hum Pathol (2003) ; 34:1265–1275.

Jauniaux E, Hempstock J, Greenwold N and Burton GJ, Trophoblastic oxidative stress in relation to temporal and regional differences in maternal placental blood flow in normal and abnormal early pregnancies. Am J Pathol (2003b) ; 162:115–125 .

Eric Jauniaux, Lucilla Poston and Graham J.Burton , Placental-related diseases of pregnancy: involvement of oxidative stress and implications in human evolution , Human Reproduction Update 2006,Vol.12, No.6 pp. 747–755.

Halliwell B, Gutteridge JMC. Free radicals in biology and medicine.4th ed. Oxford, UK: Clarendon Press; 2007 .

Valko M, Leibfritz D, Moncola J, Cronin MD, et al. Free radicals and antioxidants in normal physiological functions and human disease. Review. Int J Biochem Cell Biol 2007;39:44-84.

Valko M, Rhodes CJ, Moncol J, Izakovic M, et al. Free radicals, metals and antioxidants in oxidative stress-induced cancer. Mini-review .Chem Biol Interact. 2006;160: 1–40 .

Chatterjee M, Saluja R, Kanneganti S, et al. biochemical and molecular evaluation of neutrophil NOS in spontaneously hypertensive rats .Cell Mol Biol. 2007;53:84-93 .

Droge W. Free radicals in the physiological control of cell function .Review. Physiol Rev. 2002;82:47-95.

Willcox JK, Ash SL, Catignani GL. Antioxidants and prevention of chronic disease. Review. Crit Rev Food Sci Nutr 2004;44:275-95.

Pacher P, Beckman JS, Liaudet L. Nitric oxide and peroxynitrite in health and disease. Physiol Rev 2007;87:315-424.

Genestra M. Oxyl radicals, redox-sensitive signalling cascades and antioxidants. Review. Cell Signal. 2007;19:1807-19 .

Young I, Woodside J. Antioxidants in health and disease. J Clin Pathol. 2001;54:176–86.

Toro G , Aackermann PG. practical clinical chemistry /first edition . Boston :Little , Brown and company , 1975;634-636 .

Varley H , Gowenlock AH, Bell M. Practical Clinical Biochemistry : Hormones , vitamins , drugs , and poisons . 5th edition . London . William Heinemann medical books Ltd. 1976;(2):223-256 .

Rodkey, F.L, Estimation of serum albumin (BCG-method), Clin. Chem. 10, 606(1964).

Doumas, B.T. et al., Colorimetric test for Albumin, Clin. Chem. Acta 31, 87(1971) .

Pasquinelli F. , diagnostica e tecniche di laboratorio, (1984); Rossini editrice: page [1103 –1104 ]

Tetsuo makino , chimica clinica acta (1991) ; 197:209 – 220.

Pasquinelli F. , diagnostica e tecniche di laboratorio, [1984]; Rossini editrice: page [1099 – 1102 ]

Akita Abe ,Sumico yiamashita , Clin. Chem. [1989];35[4]:197,552-554

Buege JA . Aust SD . Microsomal lipid peroxidation method enzymol 1978 ; as 52: 302-303 .

Simsek M, Naziroglu M, Simsek H, et al. Blood plasma levels of lipoperoxides, glutathione peroxidase, beta carotene, vitamin A and E in women with habitual abortion. Cell Biochem Funct 1998;16:227–231 .

Jauniaux E, Gulbis B and Burton GJ, The human first trimester gestational sac limits rather than facilities oxygen transfer to the foetus: a review. Placenta-Trophoblast Res (2003a) ; 24:S86–S93.

Agarwal A, Gupta S, Sharma RK. Role of oxidative stress in female reproduction. Reprod Biol Endocrinol 2005; 3:28 .

Cranfield LM, Gollan JL, White AG, et al. Serum antioxidant activity in normal and abnormal subjects. Ann Clin Biochem 1979;16:299–306.

Vural P, Akgul C, Yildirim A, Canbaz M. Antioxidant defence in recurrent abortion. Clin Chim Acta 2000;295:169–177.

SB Patil , MV Kodliwadmath , Sheela M Kodliwadmath ,. Lipid peroxidation and nonenzymatic antioxidants in normal pregnancy , J Obstet Gynecol India Vol. 56, No. 5 : September/October 2006 Pg 399-401.

Ryuji Bito, Sayaka Hino, Atsushi Baba, Miharu Tanaka, Haruka Watabe and Hiroaki Kawabata. Degradation of oxidative stress-induced denatured albumin in rat liver endothelial cells, Am J Physiol Cell Physiol 2005; 289:531-542.

Jameson S. Zinc status in pregnancy: the effect of zinc therapy on perinatal mortality, prematurity, and placental ablation. Ann N Y Acad Sci 1993;678:178–92 .

A. Mezzetti et al , Copper/Zinc Ratio and systemic oxidant load: Effect of aging and aging-related degenerative diseases . Free Radical Biology & Medicine, 1998; Vol. 25, No. 6: pp. 676–681 .

Henkin, I.R., Marshall, J.R. and Meret, S. Materno fetal metabolism of copper and zinc at term. Am. J. Obstet. Gynecol. 1971; 110:131-34.

Sharma, D.C., Ajmera, P., Sharma, S. and Sharma, P. Association between serum iron and copper in pregnant anemic vegetarian women. SDMH Jour. (1999) ; 23 (1): 37-39.

Keen CL, Uriu-Hare JY, Hawk SN, Jankowski MA, Daston GP, Kwik-Uribe CL, Rucker RB. Effect of copper deficiency on prenatal development and pregnancy outcome. Am J Clin Nutr 1998; 67(suppl 5): 1003S–1011S.

Priyali Pathak et al, copper nutriture amongst pregnant women in a rural area of India , Eastern Journal of Medicine (2003) ; 8(1) :15-17 .

Carl Burtis , Edward Ashwood , Tietz textbook of clinical chemistry, second edition , trace elements ; 1994 ;2:1335- 1339 .