DOWNLOAD PDF

The Role of Antioxidants in Improving Pregnancy Outcomes

*Emmanuel Ifeanyi Obeagu1, Getrude Uzoma Obeagu2, Okechukwu Paul-Chima Ugwu3, Esther U. Alum3,4 and Jean Bosco Habimana5

1Department of Medical Laboratory Science, Kampala International University, Uganda.

2School of Nursing Science, Kampala International University, Uganda.

3Department of Publication and Extensions, Kampala International University, Uganda.

4Department of Biochemistry, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria.

5Department of Medical Laboratory Science, Mbarara University of Science and Technology, Uganda.

*Corresponding author: Emmanuel Ifeanyi Obeagu, Department of Medical Laboratory Science, Kampala International University, Uganda. emmanuelobeagu@yahoo.com, obeagu.emmanuel@kiu.ac.ug 0000-0002-4538-0161

                                                                                ABSTRACT

Pregnancy is a physiologically demanding phase marked by profound changes that elevate oxidative stress levels, posing potential risks to maternal and fetal health. Oxidative stress, resulting from an imbalance between reactive oxygen species (ROS) production and antioxidant defense mechanisms, has been implicated in various pregnancy complications. Antioxidants, renowned for their ability to counteract ROS and mitigate cellular damage, have emerged as a potential intervention to ameliorate adverse outcomes during pregnancy. The paper highlights the physiological changes in pregnancy that contribute to heightened oxidative stress, emphasizing the link between oxidative stress and complications such as pre-eclampsia, gestational diabetes, preterm birth, and intrauterine growth restriction. This paper emphasizes the imperative for robust, well-designed clinical trials to elucidate the optimal timing, dosages, and formulations of antioxidants in pregnancy. It calls for a comprehensive approach to establish clear guidelines and recommendations for antioxidant supplementation. In conclusion, this review underscores the potential of antioxidants as a promising intervention to mitigate oxidative stress-related pregnancy complications. However, the inconclusive nature of current evidence necessitates further rigorous research endeavors. Through this exploration, it accentuates the urgency for standardized protocols, ethical considerations, and extensive clinical studies to unlock the full potential of antioxidants in improving maternal and fetal health outcomes during pregnancy.

Keywords: Antioxidants, Pregnancy, Maternal Health, Fetal Health, Oxidative Stress, Reactive Oxygen Species (ROS), Preeclampsia, Gestational Diabetes, Fetal Development

INTRODUCTION

Pregnancy represents a remarkable physiological journey characterized by dynamic changes within the maternal body to nurture and sustain the developing fetus. However, this transformative process introduces heightened oxidative stress due to an imbalance between the production of reactive oxygen species (ROS) and the body’s antioxidant defense mechanisms. Oxidative stress during pregnancy has emerged as a significant factor contributing to various complications that can impact both maternal health and fetal development [1-10]. The intricate dance between oxidative stress and pregnancy outcomes has drawn substantial attention in recent years, prompting exploration into interventions that might mitigate its detrimental effects. Antioxidants, renowned for their ability to neutralize ROS and preserve cellular integrity, stand as a potential therapeutic avenue to enhance pregnancy outcomes [11-20]. This paper aims to elucidate the multifaceted relationship between oxidative stress and pregnancy complications while exploring the role of antioxidants in ameliorating adverse outcomes. It delves into the underlying mechanisms driving oxidative stress during pregnancy, the potential pathways by which antioxidants confer protective effects, and the current understanding derived from clinical studies regarding their impact on maternal-fetal health. The physiological changes inherent in pregnancy, such as increased metabolic demands, altered hormonal profiles, and placental development, significantly contribute to oxidative stress. Consequently, heightened oxidative stress has been linked to pregnancy complications including pre-eclampsia, gestational diabetes, preterm birth, and intrauterine growth restriction. Understanding these mechanisms is pivotal in elucidating the potential benefits of antioxidants in mitigating these complications [21-30]. Antioxidants, ranging from vitamins C and E to minerals and polyphenols, possess the ability to scavenge ROS and modulate oxidative stress. The paper explores how these compounds may intervene in oxidative damage, protect against inflammatory responses, improve placental function, and potentially enhance fetal development. Therefore, this paper seeks to critically examine the existing evidence, highlighting both the potential and limitations of antioxidant supplementation during pregnancy. It underscores the necessity for rigorous clinical trials, standardized protocols, and comprehensive research endeavors to ascertain the optimal use of antioxidants in enhancing maternal and fetal health during this critical period. Understanding the intricate relationship between oxidative stress and pregnancy complications offers a compelling avenue for exploring the therapeutic potential of antioxidants. By elucidating the mechanisms and challenges surrounding antioxidant interventions in pregnancy, this review aims to contribute to the quest for strategies that optimize maternal-fetal well-being and improve pregnancy outcomes.

CONCLUSION

The utilization of antioxidants as a potential intervention to alleviate oxidative stress-related complications during pregnancy offers a promising avenue to improve maternal and fetal health outcomes. However, while the theoretical benefits of antioxidants in mitigating oxidative stress are compelling, the translation of these advantages into clinical practice remains complex and inconclusive. The intricate interplay between oxidative stress and pregnancy complications underscores the significance of further research, robust clinical trials, and comprehensive longitudinal studies. These endeavors are essential to ascertain the safety, efficacy, optimal dosages, and formulations of antioxidants in diverse populations of pregnant women. The future trajectory involves enhancing research collaborations, implementing public health initiatives, and exploring innovative approaches. Longitudinal studies tracking maternal and offspring outcomes, coupled with continuous evaluation and updating of guidelines, are necessary for informed decision-making and the development of personalized approaches in antioxidant utilization. While antioxidants hold promise in mitigating oxidative stress-related complications during pregnancy, there exists a crucial need for conclusive evidence to guide their optimal use. Addressing challenges, fostering collaborations, and advancing research endeavors are imperative to harness the full potential of antioxidants in optimizing maternal and fetal health outcomes. Through these collective efforts, the journey towards establishing evidence-based recommendations for antioxidant supplementation in pregnancy will undoubtedly contribute to improving the health and well-being of both mothers and their offspring.

REFERENCES

  1. Ifeanyi OE. A review on free radicals and antioxidants. Int. J. Curr. Res. Med. Sci. 2018;4(2):123-33.
  2. Obeagu EI, Obeagu GU, Obiezu J, Ezeonwumelu C, Alum EU, Ugwu OP. Antioxidants and Pregnancy: Impact on Maternal and Fetal Health. APPLIED SCIENCES (NIJBAS). 2023;4(1).
  3. Obeagu EI, Bunu UO, Obeagu GU, Habimana JB. Antioxidants in the management of sickle cell anaemia: an area to be exploited for the wellbeing of the patients. International Research in Medical and Health Sciences. 2023;6(4):12-7.
  4. Obeagu EI, Ubosi NI, Uzoma G. Antioxidant Supplementation in Pregnancy: Effects on Maternal and Infant Health. Int. J. Adv. Multidiscip. Res. 2023;10(11):60-70.
  5. Obeagu EI, Obeagu GU. Utilization of Antioxidants in the management of diabetes mellitus patients. J Diabetes Clin Prac. 2018;1(102):2.
  6. Obeagu EI, Agreen FC. Anaemia among pregnant women: A review of African pregnant teenagers. J Pub Health Nutri. 2023; 6 (1). 2023;138. links/63da799664fc860638054562/Anaemia-among-pregnant-women-A-review-of-African-pregnant-teenagers.pdf.
  7. Obeagu EI, Ezimah AC, Obeagu GU. Erythropoietin in the anaemias of pregnancy: a review. Int J Curr Res Chem Pharm Sci. 2016;3(3):10-8. links/5710fae108ae846f4ef05afb/ERYTHROPOIETIN-IN-THE-ANAEMIAS-OF-PREGNANCY-A-REVIEW.pdf.
  8. Obeagu EI, Adepoju OJ, Okafor CJ, Obeagu GU, Ibekwe AM, Okpala PU, Agu CC. Assessment of Haematological Changes in Pregnant Women of Ido, Ondo State, Nigeria. J Res Med Dent Sci. 2021 Apr;9(4):145-8. links/608a6728a6fdccaebdf52d94/Assessment-of-Haematological-Changes-in-Pregnant-Women-of-Ido-Ondo.pdf.
  9. Obeagu EI, Obeagu GU. Sickle Cell Anaemia in Pregnancy: A Review. International Research in Medical and Health Sciences. 2023;6(2):10-3. http://irmhs.com/index.php/irmhs/article/view/111.
  10. Jakheng SP, Obeagu EI. Seroprevalence of human immunodeficiency virus based on demographic and risk factors among pregnant women attending clinics in Zaria Metropolis, Nigeria. J Pub Health Nutri. 2022; 5 (8). 2022;137. links/6317a6b1acd814437f0ad268/Seroprevalence-of-human-immunodeficiency-virus-based-on-demographic-and-risk-factors-among-pregnant-women-attending-clinics-in-Zaria-Metropolis-Nigeria.pdf.
  11. Nwosu DC, Obeagu EI, Nkwocha BC, Nwanna CA, Nwanjo HU, Amadike JN, Elendu HN, Ofoedeme CN, Ozims SJ, Nwankpa P. Change in Lipid Peroxidation Marker (MDA) and Non enzymatic Antioxidants (VIT C & E) in HIV Seropositive Children in an Urban Community of Abia State. Nigeria. J. Bio. Innov. 2016;5(1):24-30.
  12. Nwosu DC, Obeagu EI, Ezenwuba C, Agu GC, Amah H, Ozims SJ, Nwanjo HU, Edward A, Izuchukwu IF, Amadike JN, Nwagwu AJ. Antioxidant status of children with Plasmodium falciparum malaria in Owerri municipal council of Imo state. Int. J. Curr. Res. Chem. Pharm. Sci. 2016;3(8):40-6.
  13. Ezimah UA, Obeagu EI, Ezimah CO, Ezimah A, Nto NJ. Diarrhoeal diseases of acquired immunodeficiency syndrome stimulate more depletion of total antioxidant status. Int. J. Adv. Multidiscip. Res. 2016;3(4):23-5.
  14. Aloh GS, Obeagu EI, Okoroiwu IL, Odo CE, Chibunna OM, Kanu SN, Elemchukwu Q, Okpara KE, Ugwu GU. Antioxidant-Mediated Heinz Bodies Levels of Sickle Erythrocytes under Drug-Induced Oxidative Stress. European Journal of Biomedical and Pharmaceutical sciences. 2015;2(1):502-7.
  15. Alum EU, Aja W, Ugwu OP, Obeagu EI, Okon MB. Assessment of vitamin composition of ethanol leaf and seed extracts of datura stramonium. Avicenna J Med Biochem. 2023;11(1):92-7.
  16. Alum EU, Inya JE, Ugwu OP, Obeagu EI, Aloke C, Aja PM, Okpata MG, John EC, Orji MO, Onyema O. Ethanolic leaf extract of Datura stramonium attenuates methotrexate-induced biochemical alterations in Wistar Albino rats. RPS Pharmacy and Pharmacology Reports. 2023;2(1): rqac011.
  17. Nwakuilite A, Nwanjo HU, Nwosu DC, Obeagu EI. EVALUATION OF ENZYME ANTIOXIDANTS IN STREPTOZOCIN INDUCED DIABETIC RATS TREATED WITH MORINGA OLEIFERA LEAF POWDER. European Journal of Biomedical. 2020;7(11):285-8.
  18. Akinpelu M, Gamade SM, Akinbo F, Adeniyi TD, Elizebeth AF, Obeagu EI. Histopathological and Biochemical Effect of Vitamin C and D on Phosphine-Induced Hepatotoxicity in Wistar Rats. Asian Journal of Dental and Health Sciences. 2023;3(2):18-22.
  19. Nwakulite A, Obeagu EI, Eze R, Ugochi VE, Vincent CC, Okafor CJ, Chukwurah EF, Unaeze BC, Amaechi CO, Okwuanaso CB, Chukwuani U. Estimation of Serum Glutathione Peroxidase in Streptozotocin Induced Diabetic Rat Treated with Bitter Leaf Extract. Journal of Pharmaceutical Research International. 2021;33(30B):200-6.
  20. Ifeanyi OE, Stella EI, Favour AA. Antioxidants In the Management of Sickle Cell Anaemia. Int J Hematol Blood Disord (Internet) 2018 (cited 2021 Mar 4); 3. Available from: https://symbiosisonlinepublishing. com/hematology/hema tology25. php. 2018 S.
  21. Obeagu EI, Obeagu GU, Chukwueze CM, Ikpenwa JN, Ramos GF. Evaluation of Protein C, Protein S and Fibrinogen of Pregnant Women with Malaria in Owerri Metropolis. Madonna University journal of Medicine and Health Sciences. 2022 ;2(2):1-9.
  22. Obeagu EI, Ikpenwa JN, Chukwueze CM, Obeagu GU. Evaluation of protein C, protein S and fibrinogen of pregnant women in Owerri Metropolis. Madonna University Journal of Medicine and Health Sciences. 2022;2(1):292-8. https://madonnauniversity.edu.ng/journals/index.php/medicine/article/view/57.
  23. Obeagu EI, Obeagu GU, Adepoju OJ. Evaluation of haematological parameters of pregnant women based on age groups in Olorunsogo road area of Ido, Ondo state. J. Bio. Innov11 (3). 2022:936-41.
  24. Obeagu EI. An update on utilization of antenatal care among pregnant Women in Nigeria. Int. J. Curr. Res. Chem. Pharm. Sci. 2022;9(9): 21-6.DOI:22192/ijcrcps.2022.09.09.003
  25. Okoroiwu IL, Obeagu EI, Obeagu GU. Determination of clot retraction in preganant women attending antenatal clinic in federal medical centre Owerri, Nigeria. Madonna University Journal of Medicine and Health Sciences. 2022;2(2):91-7. https://madonnauniversity.edu.ng/journals/index.php/medicine/article/view/67.
  26. Obeagu EI, Hassan AO, Adepoju OJ, Obeagu GU, Okafor CJ. Evaluation of Changes in Haematological Parameters of Pregnant Women Based on Gestational Age at Olorunsogo Road Area of Ido, Ondo State. Nigeria. Journal of Research in Medical and Dental Science. 2021;9(12):462-.links/61b1e32f0c4bfb675178bfa7/Evaluation-of-Changes-in-Haematological-Parameters-of-Pregnant-Women-Based-on-Gestational-Age-at-Olorunsogo-Road-Area-of-Ido-Ondo-State-Nigeria.pdf.
  27. Anyiam AF, Obeagu EI, Obi E, Omosigho PO, Irondi EA, Arinze-Anyiam OC, Asiyah MK. ABO blood groups and gestational diabetes among pregnant women attending University of Ilorin Teaching Hospital, Kwara State, Nigeria. International Journal of Research and Reports in Hematology. 2022;5(2):113-21.
  28. Obeagu EI. Gestational Thrombocytopaenia. J Gynecol Women’s Health. 2023;25(3):556163. links/64b01aa88de7ed28ba95fccb/Gestational-Thrombocytopaenia.pdf.
  29. Jakheng SP, Obeagu EI, Abdullahi IO, Jakheng EW, Chukwueze CM, Eze GC, Essien UC, Madekwe CC, Madekwe CC, Vidya S, Kumar S. Distribution Rate of Chlamydial Infection According to Demographic Factors among Pregnant Women Attending Clinics in Zaria Metropolis, Kaduna State, Nigeria. South Asian Journal of Research in Microbiology. 2022;13(2):26-31.
  30. Obeagu EI, Ogbonna US, Nwachukwu AC, Ochiabuto O, Enweani IB, Ezeoru VC. Prevalence of Malaria with Anaemia and HIV status in women of reproductive age in Onitsha, Nigeria. Journal of Pharmaceutical Research International. 2021;33(4):10-9.
  31. Obeagu EI, Abdirahman BF, Bunu UO, Obeagu GU. Obsterics characteristics that effect the newborn outcomes. Int. J. Adv. Res. Biol. Sci. 2023;10(3): 134-43.DOI:22192/ijarbs.2023.10.03.016
  32. Obeagu EI, Ogunnaya FU. PREGNANCYINDUCED HAEMATOLOGICAL CHANGES: A KEY TO MARTERNAL AND CHILD HEALTH. European Journal of Biomedical. 2023;10(8):42-3. links/64c890bddb38b20d6dad2c5c/PREGNANCY-INDUCED-HAEMATOLOGICAL-CHANGES-A-KEY-TO-MARTERNAL-AND-CHILD-HEALTH.pdf.
  33. Ezeoru VC, Enweani IB, Ochiabuto O, Nwachukwu AC, Ogbonna US, Obeagu EI. Prevalence of Malaria with Anaemia and HIV status in women of reproductive age in Onitsha, Nigeria. Journal of Pharmaceutical Research International. 2021;33(4):10-9.
  34. Okamgba OC, Nwosu DC, Nwobodo EI, Agu GC, Ozims SJ, Obeagu EI, Ibanga IE, Obioma-Elemba IE, Ihekaire DE, Obasi CC, Amah HC. Iron Status of Pregnant and Post-Partum Women with Malaria Parasitaemia in Aba Abia State, Nigeria. Annals of Clinical and Laboratory Research. 2017;5(4):206. links/5ea97df145851592d6a8acf2/Iron-Status-of-Pregnant-and-Post-Partum-Women-with-Malaria-Parasitaemia-in-Aba-Abia-State-Nigeria.pdf.
  35. Eze RI, Obeagu EI, Edet FN. Frequency of Rh Antigen C And c among pregnant women in Sub-Urban area in Eastern Nigeria. Madonna Uni J Med Health Sci. 2021;1(1):19-30.
  36. Obeagu EI, Ofodile AC, Okwuanaso CB. A review of urinary tract infections in pregnant women: Risks factors. J Pub Health Nutri. 2023; 6 (1). 2023; 137:26-35. links/63c3a9116fe15d6a571e8bba/A-review-of-urinary-tract-infections-in-pregnant-women-Risks-factors.pdf.
  37. Obeagu EI, Obeagu GU, Musiimenta E. Post partum haemorrhage among pregnant women: Update on risks factors. Int. J. Curr. Res. Med. Sci. 2023;9(2): 14-7.DOI:22192/ijcrms.2023.09.02.003
  38. Obeagu EI, Obeagu GU, Ogunnaya FU. Deep vein thrombosis in pregnancy: A review of prevalence and risk factors. Int. J. Curr. Res. Chem. Pharm. Sci. 2023;10(8): 14-21.DOI:22192/ijcrcps.2023.10.08.002
  39. Jakheng SP, Obeagu EI, Jakheng EW, Uwakwe OS, Eze GC, Obeagu GU, Vidya S, Kumar S. Occurrence of Chlamydial Infection Based on Clinical Symptoms and Clinical History among Pregnant Women Attending Clinics in Zaria Metropolis, Kaduna State, Nigeria. International Journal of Research and Reports in Gynaecology. 2022;5(3):98-105.
  40. Okorie HM, Obeagu EI, Eze EN, Jeremiah ZA. Assessment of some haematological parameters in malaria infected pregnant women in Imo state Nigeria. Int. J. Curr. Res. Biol. Med. 2018;3(9):1-4.DOI:22192/ijcrbm.2018.03.09.001
  41. Al-Gubory KH, Fowler PA, Garrel C. The roles of cellular reactive oxygen species, oxidative stress and antioxidants in pregnancy outcomes. The international journal of biochemistry & cell biology. 2010;42(10):1634-50.
  42. Onyenweaku FC, Amah HC, Obeagu EI, Nwandikor UU, Onwuasoanya UF. Prevalence of asymptomatic bacteriuria and its antibiotic susceptibility pattern in pregnant women attending private ante natal clinics in Umuahia Metropolitan. Int J Curr Res Biol Med. 2017;2(2): 13-23.DOI:22192/ijcrbm.2017.02.02.003
  43. Okoroiwu IL, Chinedu-Madu JU, Obeagu EI, Vincent CC, Ochiabuto OM, Ibekwe AM, Amaechi CO, Agu CC, Anoh NV, Amadi NM. Evaluation of Iron Status, Haemoglobin and Protein Levels of Pregnant Women in Owerri Metropolis. Journal of Pharmaceutical Research International. 2021;33(27A):36-43.
  44. Obeagu EI, Njar VE, Obeagu GU. Infertility: Prevalence and Consequences. Int. J. Curr. Res. Chem. Pharm. Sci. 2023;10(7):43-50.
  45. Emeka-Obi OR, Ibeh NC, Obeagu EI, Okorie HM. Evaluation of levels of some inflammatory cytokines in preeclamptic women in owerri. Journal of Pharmaceutical Research International. 2021;33(42A):53-65.
  46. Obeagu EI, Faduma MH, Uzoma G. Ectopic Pregnancy: A Review. Int. J. Curr. Res. Chem. Pharm. Sci. 2023;10(4): 40-4.DOI: 22192/ijcrcps.2023.10.04.004
  47. Lushchak VI. Free radicals, reactive oxygen species, oxidative stress and its classification. Chemico-biological interactions. 2014; 224:164-75.
  48. Obeagu EI, Gamade SM, Obeagu GU. The roles of Neutrophils in pregnancy. Int. J. Curr. Res. Med. Sci. 2023;9(5): 31-5.DOI: 22192/ijcrms.2023.09.05.005
  49. Eze R, Obeagu EI, Nwakulite A, Okoroiwu IL, Vincent CC, Okafor CJ, Chukwurah EF, Chijioke UO, Amaechi CO. Evaluation of Copper Status and Some Red Cell Parameters of Pregnant Women in Enugu State, South Eastern Nigeria. Journal of Pharmaceutical Research International. 2021;33(30A):67-71.
  50. Obeagu EI, Obeagu GU. Molar Pregnancy: Update of prevalence and risk factors. Int. J. Curr. Res. Med. Sci. 2023;9(7): 25-8.DOI: 22192/ijcrms.2023.09.07.005
  51. Obeagu EI, Bunu UO. Factors that influence unmet need for family planning. International Journal of Current Research in Biology and Medicine. 2023;8(1):23-7.
  52. Ibebuike JE, Ojie CA, Nwokike GI, Obeagu EI, Nwosu DC, Nwanjo HU, Agu GC, Ezenwuba CO, Nwagu SA, Akujuobi AU. Barriers to utilization of maternal health services in southern senatorial district of Cross Rivers state, Nigeria. International Journal of Advanced Multidisciplinary Research. 2017;4(8): 1-9.DOI: 22192/ijamr.2017.04.08.001
  53. Aouache R, Biquard L, Vaiman D, Miralles F. Oxidative stress in preeclampsia and placental diseases. International journal of molecular sciences. 2018;19(5):1496.
  54. Emannuel G, Martin O, Peter OS, Obeagu EI, Daniel K. Factors Influencing Early Neonatal Adverse Outcomes among Women with HIV with Post Dated Pregnancies Delivering at Kampala International University Teaching Hospital, Uganda. Asian Journal of Pregnancy and Childbirth. 2023;6(1):203-11. http://research.sdpublishers.net/id/eprint/2819/.
  55. Okorie HM, Obeagu EI, Eze EN, Jeremiah ZA. Assessment of coagulation parameters in malaria infected pregnant women in Imo state, Nigeria. International Journal of Current Research in Medical Sciences. 2018;4(9): 41-9.DOI:22192/ijcrms.2018.04.09.006
  56. Obeagu EI, Obeagu GU. Postpartum haemorrhage among women delivering through spontaneous vaginal delivery: Prevalence and risk factors. Int. J. Curr. Res. Chem. Pharm. Sci. 2023;10(8): 22-6.DOI: 22192/ijcrcps.2023.10.08.003
  57. Obeagu E, Eze RI, Obeagu EI, Nnatuanya IN, Dara EC. ZINC LEVEL IN APPARENTLY PREGNANT WOMEN IN URBAN AREA. Madonna University journal of Medicine and Health Sciences. 2022;2(1):134-48. https://www.journal.madonnauniversity.edu.ng/index.php/medicine/article/view/40.
  58. Lappas M, Hiden U, Desoye G, Froehlich J, Mouzon SH, Jawerbaum A. The role of oxidative stress in the pathophysiology of gestational diabetes mellitus. Antioxidants & redox signaling. 2011;15(12):3061-100.
  59. Ogomaka IA, Obeagu EI. Malaria in Pregnancy Amidst Possession of Insecticide Treated Bed Nets (ITNs) in Orlu LGA of Imo State, Nigeria. Journal of Pharmaceutical Research International. 2021;33(41B):380-6.
  60. Obeagu EI, Ogunnaya FU, Obeagu GU, Ndidi AC. SICKLE CELL ANAEMIA: A GESTATIONAL ENIGMA. migration. 2023; 17:18.
  61. Ifeanyi OE, Uzoma OG. A review on erythropietin in pregnancy. J. Gynecol. Womens Health. 2018;8(3):1-4. https://www.academia.edu/download/56538560/A_Review_on_Erythropietin_in_Pregnancy.pdf.
  62. Ifeanyi OE. A review on pregnancy and haematology. Int. J. Curr. Res. Biol. Med. 2018;3(5): 26-8.DOI: 22192/ijcrbm.2018.03.05.006
  63. Nwosu DC, Nwanjo HU, Obeagu EI, Ibebuike JE, Ezeama MC. Ihekireh. Changes in liver enzymes and lipid profile of pregnant women with malaria in Owerri, Nigeria. International Journal of Current Research and Academic Review. 2015;3(5):376-83.
  64. Ibebuike JE, Ojie CA, Nwokike GI, Obeagu EI, Nwosu DC, Nwanjo HU, Agu GC, Ezenwuba CO, Nwagu SA, Akujuobi AU. Factors that influence women’s utilization of primary health care services in Calabar Cros river state, Nigeria. Int. J. Curr. Res. Chem. Pharm. Sci. 2017;4(7):28-33.
  65. Eze R, Ezeah GA, Obeagu EI, Omeje C, Nwakulite A. Evaluation of iron status and some haematological parameters of pregnant women in Enugu, South Eastern Nigeria. World Journal of Pharmaceutical and Medical Research. 2021;7(5):251-4.
  66. Elemchukwu Q, Obeagu EI, Ochei KC. Prevalence of Anaemia among Pregnant Women in Braithwaite Memorial Specialist Hospital (BMSH) Port Harcourt. IOSR Journal of Pharmacy and Biological Sciences. 2014;9(5):59-64.
  67. Akandinda M, Obeagu EI, Katonera MT. Non Governmental Organizations and Women’s Health Empowerment in Uganda: A Review. Asian Research Journal of Gynaecology and Obstetrics. 2022 Dec 14;8(3):12-6.
  68. Vidya S. Sunil Kumar Shango Patience Emmanuel Jakheng, Emmanuel Ifeanyi Obeagu, Emmanuel William Jakheng, Onyekachi Splendid Uwakwe, Gloria Chizoba Eze, and Getrude Uzoma Obeagu (2022). Occurrence of Chlamydial Infection Based on Clinical Symptoms and Clinical History among Pregnant Women Attending Clinics in Zaria Metropolis, Kaduna State, Nigeria. International Journal of Research and Reports in Gynaecology.;5(3):98-105.
  69. Gamde MS, Obeagu EI. IRON DEFICIENCY ANAEMIA: ENEMICAL TO PREGNANCY. European Journal of Biomedical. 2023;10(9):272-5. links/64f63358827074313ffaae7b/IRON-DEFICIENCY-ANAEMIA-ENEMICAL-TO-PREGNANCY.pdf.
  70. Emeka-Obi OR, Ibeh NC, Obeagu EI, Okorie HM. Evaluation of levels of some inflammatory cytokines in preeclamptic women in owerri. Journal of Pharmaceutical Research International. 2021;33(42A):53-65.
  71. Emeka-Obi OR, Ibeh NC, Obeagu EI, Okorie HM. Studies of Some Haemostatic Variables in Preeclamptic Women in Owerri, Imo State, Nigeria. Journal of Pharmaceutical Research International. 2021;33(42B):39-48.
  72. Obeagu EI, Obeagu GU, Obiezu J, Ezeonwumelu C, Alum EU, Ugwu OP. Antioxidants and Pregnancy: Impact on Maternal and Fetal Health. APPLIED SCIENCES (NIJBAS). 2023;4(1).
  73. Obeagu EI, Obeagu GU. Postpartum haemorrhage among women delivering through spontaneous vaginal delivery: Prevalence and risk factors. Int. J. Curr. Res. Chem. Pharm. Sci. 2023;10(8):22-6.
  74. Obeagu EI, Obeagu GU. Sickle Cell Anaemia in Pregnancy: A Review. International Research in Medical and Health Sciences. 2023 ;6(2):10-3.
  75. Adwas AA, Elsayed A, Azab AE, Quwaydir FA. Oxidative stress and antioxidant mechanisms in human body. J. Appl. Biotechnol. Bioeng. 2019;6(1):43-7.
  76. Marín R, Chiarello DI, Abad C, Rojas D, Toledo F, Sobrevia L. Oxidative stress and mitochondrial dysfunction in early-onset and late-onset preeclampsia. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease. 2020;1866(12):165961.

CITE AS: Emmanuel Ifeanyi Obeagu, Getrude Uzoma Obeagu, Okechukwu Paul-Chima Ugwu, Esther U. Alum and Jean Bosco Habimana (2024).The Role of Antioxidants in Improving Pregnancy Outcomes. IAA Journal of Applied Sciences 11(1):40-48. https://doi.org/10.59298/IAAJAS/2024/5.58.33.11

DOWNLOAD PDF