Objective: The concerted iron-binding antioxidant activity of transferrin and ceruloplasmin decreases with increasing transferrin saturation by iron. We examined interactions between serum iron and iron-binding capacity and concentrations of the lipid peroxidation metabolite malondialdehyde in normal and preeclamptic pregnancies. We also asked if the release of iron from free hemoglobin by lipid hydroperoxides is a potential mechanism to increase transferrin saturation in preeclampsia.
Study design: Predelivery and 24 to 48 hour postpartum venous blood was collected from 19 women with uncomplicated pregnancies and 17 with preeclampsia. Serum iron, iron binding capacity, and malondialdehyde were measured. In a subset of predelivery samples electron paramagnetic resonance spectroscopy was used to determine diferric transferrin, total transferrin, and ceruloplasmin concentrations and to examine interactions of an organic hydroperoxide with hemoglobin and transferrin.
Results: Antepartum serum iron concentrations were 46% greater, percent saturation of iron binding capacity was 98% greater, and malondialdehyde 50% greater, whereas total iron-binding capacity was 14% lower, in women with preeclampsia. By 48 hours post partum group differences between these variables other than total iron-binding capacity were not observed. Electron paramagnetic resonance spectroscopy confirmed antepartum differences and that total iron-binding capacity and percent saturation were equivalent to total transferrin and the ratio diferric transferrin/total transferrin, respectively. Antepartum concentrations of ceruloplasmin were not different. Antepartum malondialdehyde concentrations correlated positively with percent transferrin saturation and negatively with unsaturated iron-binding capacity (apotransferrin). Electron paramagnetic resonance spectroscopy demonstrated that the release of iron from free hemoglobin by lipid hydroperoxides in serum is a potential mechanism to increase transferrin saturation.
Conclusion: Increased transferrin saturation and decreased unsaturated iron-binding capacity in preeclampsia may occur consequent to oxidative stress and then further promote oxidative stress by decreasing serum antioxidant buffering against redox-active iron.