The role of antioxidant defense enzymes in the placenta and fetal membranes in preterm birth

DOI

https://dx.doi.org/10.18565/aig.2026.111

Medzhidova M.К., Tyutyunnik V.L., Kan N.E., Manukhova L.A., Marey M.V., Vysokikh M.Yu.
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation, Moscow, Russia

Objective. To assess the levels of antioxidant defense enzymes involved in regulating oxidative stress in the placenta and fetal membranes during preterm birth (PTB).
Materials and methods. This prospective study was conducted between 2013 and 2021 at V. I. Kulakov National Medical Research Center for Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, and Perinatal City Clinical Hospital No. 24 of the Moscow Department of Healthcare between 2013 and 2021. Patients were enrolled consecutively in the study. The primary outcomes were the expression levels of SOD1, SOD2, GPX1, and catalase proteins in placental and fetal membrane tissues. The secondary outcomes were between-group differences based on the etiology and gestational age at PTB.
A total of 64 women with spontaneous PTB at 22.0–37.0 weeks of gestation who delivered vaginally were enrolled. Patients were divided into groups according to gestational age: group 1 comprised 14 women with extremely early PTB (22.0–27.6 weeks of gestation); group 2 comprised 16 women with early PTB (28.0–31.6 weeks); group 3 comprised 17 women with PTB (32.0–33.6 weeks); and group 4 comprised 19 women with late PTB (34.0–36.6 weeks). Given the different etiologies of spontaneous preterm birth (SPB) and PTB caused by preterm prelabor rupture of membranes (PPROM), the patients were further divided into two subgroups: 34 patients with PPROM and 32 women with SPB. For comparison, a group of women with physiological pregnancies and spontaneous term vaginal deliveries at 37.0–41.0 weeks’ gestation was included (n=20).
Results. In PTB associated with PPROM, there were statistically significant reductions in all antioxidant defense enzymes and an imbalance in the antioxidant defense system in the fetal membranes. These changes were particularly pronounced in extremely early PTB at 22.0–27.6 weeks’ gestation. In the placenta, however, this process was selective, manifested by a reduction in catalase levels only at 28.0–34.0 weeks, which may be regarded as a consequence of depletion of the maternal–placental–fetal system's reserves by these gestational ages during the development of PPROM. In contrast, in SPB without rupture of the fetal membranes, the most pronounced reduction in antioxidant defense enzymes was observed in the placenta. The statistically significant reduction in all key antioxidant defense enzymes in the placenta in extremely early PTB indicates that placental oxidative stress is the initiating mechanism underlying the onset of labor in SPB, whereas no significant reduction in antioxidant defense enzymes occurred in fetal membranes.
Conclusion. In PTB associated with PPROM, a statistically significant reduction in antioxidant defense enzyme levels was identified in the fetal membranes, where pathological processes initially appeared to develop. Changes in the placenta develop secondarily as a consequence of the depletion of antioxidant defense reserves at later gestational ages. In contrast, in SPB without PPROM, the most pronounced reduction in antioxidant defense enzymes was predominantly associated with changes in the placenta.

Authors' contributions. Medzhidova M.K., Tyutyunnik V.L., Kan N.E., Vysokikh M.Yu., Marey M.V. – conception and design of the study; Medzhidova M.K., Manukhova L.A., Marey M.V. – obtaining data for analysis, processing and analyzing material on the topic; Medzhidova M.K. – drafting of the manuscript; Tyutyunnik V.L., Kan N.E., Vysokikh M.Yu. – editing of the manuscript.
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. There was no funding for this study.
Ethical Approval. The study was reviewed and approved by the Research Ethics Committee of the V.I. Kulakov NMRC for OG&P.
Patient Consent for Publication. All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement. The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Medzhidova M.К., Tyutyunnik V.L., Kan N.E., Manukhova L.A., Marey M.V., Vysokikh M.Yu.
The role of antioxidant defense enzymes in the placenta and fetal membranes in preterm birth.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (8): 93-100 (in Russian)
https://dx.doi.org/10.18565/aig.2026.111

preterm birth

spontaneous preterm birth

preterm prelabor rupture of membranes

antioxidant defense enzymes

oxidative stress

Full text (in Russian)

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Received 02.04.2026

Accepted 30.07.2026

Marzhanat К. Medzhidova, PhD, Doctoral Student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(926)381-17-10, marzhana-m@yandex.ru, Researcher ID: GRR-7195-2022, SPIN-code: 5942-2320,
Authors ID: 116298611:49, Scopus Author ID: 57191960453, https://orcid.org/0000-0001-6938-4207
Victor L. Tyutyunnik, Professor, Dr. Med. Sci., Leading Researcher at the Center for Scientific and Clinical Research, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(903)969-50-41, tioutiounnik@mail.ru, Researcher ID: B-2364-2015, SPIN-code: 1963-1359, Authors ID: 213217, Scopus Author ID: 56190621500, https://orcid.org/0000-0002-5830-5099
Natalia E. Kan, Professor, Dr. Med. Sci., Deputy Director of Science, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(926)220-86-55, kan-med@mail.ru, Researcher ID: B-2370-2015,
SPIN-code: 5378-8437, Authors ID: 624900, Scopus Author ID: 57008835600, https://orcid.org/0000-0001-5087-5946
Lyudmila A. Manukhova, Researcher at the Mitochondrial Medicine Research Group, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russia, 117997, Russia, Moscow, Ac. Oparina str., 4.
Maria V. Marey, PhD (Bio), Senior Researcher at the Mitochondrial Medicine Research Group, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, m_marey@oparina4.ru
Mikhail Yu. Vysokikh, PhD, Head of Mitochondrial Medicine Research Group, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(495)438-76-33 (ex. 1472), m_vysokikh@oparina4.ru,
Researcher ID: H-4744-2014, SPIN-code: 2742-0833, Authors ID: 6602218584, Scopus Author ID: 57008835600, https://orcid.org/0000-0002-4047-6201
Corresponding author: Marzhanat К. Medzhidova, marzhana-m@yandex.ru

The role of antioxidant defense enzymes in the placenta and fetal membranes in preterm birth

Medzhidova M.К., Tyutyunnik V.L., Kan N.E., Manukhova L.A., Marey M.V., Vysokikh M.Yu.

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