Differential Plasma Carotenoids Profiles in Hypertensive Disorders of Pregnancy

Background: /Objectives: Hypertensive disorders of pregnancy (HDP) affect one in six pregnancies globally and contribute to over 40,000 maternal and 500,000 neonatal deaths annually. The etiology of HDP remains unclear, but oxidative stress is known to impair maternal vascular function and fetal development. While the body produces endogenous antioxidants, antioxidative nutrients, like carotenoids, remain critical in modulating oxidative stress. Carotenoids are a diverse class of bioactive pigments with antioxidative properties. Status of several carotenoids have been linked to hypertension in both pregnant and non-pregnant populations. However, their association with the spectrum of HDP, including gestational hypertension (GH), chronic hypertension (CH), and preeclampsia (PE), remains unclear. Methods: We quantified dietary carotenoid intake (via food frequency questionnaire) and plasma carotenoid levels (via mass spectrometry) in 488 and 225 pregnant patients, respectively, presenting for delivery at a large Midwestern academic medical center. Carotenoid levels were compared across HDP groups using Kruskal-Wallis tests with Dunn’s post-hoc multiple comparisons tests (threshold of significance at p<0.05). Results: Plasma total, cis- and trans-β-carotene were significantly lower in PE compared to normotensive (NT), CH, and GH groups. Lutein and β-cryptoxanthin were also reduced in PE compared to NT but only β-cryptoxanthin was lower in PE compared to GH. Levels of α-carotene were lower in PE compared to both CH and GH. No significant differences in dietary carotenoid intake were observed across HDP groups. Conclusions: These findings suggest that oxidative stress in PE may deplete circulating carotenoids, differentiating it from other HDP. Future studies should explore potential synergism of carotenoids in mitigating oxidative stress and temporal changes in carotenoid levels throughout pregnancy to further assess the role of carotenoids as therapeutic targets and biomarkers for PE.