# A Narrative Review of Oxidative Stress and Liver Disease in Pregnancy: The Role of Antioxidants

## TL;DR

This review explores how oxidative stress contributes to liver diseases during pregnancy and whether antioxidants like vitamins C and E can help improve maternal and fetal outcomes.

## Contribution

The paper provides a narrative review of antioxidant use in pregnancy-related liver disorders, highlighting gaps in clinical evidence and the need for standardized trials.

## Key findings

- Vitamins C and E are the most studied antioxidants for addressing oxidative stress in pregnancy-related liver disorders.
- Current evidence suggests potential benefits of antioxidants in conditions like preeclampsia and HELLP syndrome, but findings are not robust.
- Well-designed clinical trials are needed to determine optimal timing and dosage of antioxidant supplementation during pregnancy.

## Abstract

Pregnancy brings numerous physiological changes to the body of the pregnant woman. Liver diseases in pregnancy contribute to increased oxidative stress, disrupting the delicate balance between reactive oxygen species and antioxidant defence. Antioxidant supplementation may have potential benefits in addressing pregnancy-related liver disorders, such as HELLP (haemolysis, elevated liver enzymes, low platelet count) and preeclampsia-associated liver dysfunction in pregnancy.

The purpose of this narrative review is to review the evidence regarding oxidative stress in liver disorders during pregnancy and the role of antioxidants in alleviating oxidative stress and its effect on maternal and foetal outcomes. A narrative review study design involved a comprehensive search across three scientific databases: PubMed, Embase, and MEDLINE, published in the last 20 years. The searches were performed up to January 2024.

Thirty-two studies were included in the narrative review. The most studied antioxidants were vitamins (vitamin C and E) for their role in clinical treatment, prophylaxis, and clearing surrogate oxidative stress markers. The majority of studies were on preeclampsia. Though the existing literature is not robust, available evidence suggests that antioxidant supplementation may have potential benefits in addressing pregnancy-related liver disorders, such as HELLP and preeclampsia-associated liver dysfunction in pregnancy. However, there is a need to establish consistent protocols, ethical standards, and well-designed clinical trials to clarify the timing and dosage of antioxidants in pregnancy.

Antioxidants may alleviate the oxidative stress in various liver disorders during pregnancy, which still needs to be studied further for their clinical relevance.