A prospective study of early-pregnancy plasma malondialdehyde concentration and risk of preeclampsia

Objectives: Preeclampsia is associated with elevated plasma malondialdehyde concentration, but prospective data are scarce. We examined the relation between early-pregnancy plasma malondialdehyde and subsequent preeclampsia risk. Design and methods: In a nested case–control analysis, we measured malondialdehyde concentrations in 22 women who developed preeclampsia and 711 who remained normotensive during pregnancy. We calculated adjusted odds ratios (OR) and 95% confidence intervals (CI). We repeated analyses after adjustment for early-pregnancy plasma lipid concentrations, which are related to preeclampsia risk and lipid peroxidation measures. Results: After adjustment for confounders, preeclampsia risk increased across tertiles of malondialdehyde concentration (trend P = 0.04). Further adjustment for triglyceride concentration slightly strengthened the association. Middle- and high-tertile malondialdehyde ORs were 3.2 (CI 0.8–12.2) and 4.2 (1.1–16.0) versus low-tertile exposure. Conclusions: Early-pregnancy plasma malondialdehyde concentration is positively associated with subsequent preeclampsia risk independent of plasma lipid concentrations. These results support lipid peroxidation as an etiologic component of preeclampsia.