Differential Plasma Carotenoid Profiles in Hypertensive Disorders of Pregnancy

<b>Background</b>: Hypertensive disorders of pregnancy (HDP) affect one in six pregnancies globally. The etiology of HDP remains unclear but is known to involve oxidative stress. While the body produces endogenous antioxidants, antioxidative nutrients, like carotenoids, remain critical in modulating oxidative stress. The statuses of several carotenoids have been linked to hypertension in both pregnant and non-pregnant populations. However, their associations with the spectrum of HDP, including gestational hypertension (GH), chronic hypertension (CH), and preeclampsia (PE), remains unclear. Our objective was to quantify and compare carotenoid intake and plasma levels among HDP. <b>Methods</b>: We conducted a prospective cohort study of patients presenting for delivery at a Midwestern academic medical center between 2015 and 2023. Women ≥ 19 years old delivering at least one infant were eligible for inclusion. Mothers with diseases affecting nutrient metabolism or birthing newborn wards of the state were excluded. Subjects were recruited at delivery for Harvard Food Frequency Questionnaire and plasma sample collection. Plasma carotenoids were analyzed by HPLC-MS. <b>Results</b>: A total of 488 patients, including 270 normotensive (NT), 61 CH, 102 GH, and 55 PE, were recruited. Plasma carotenoid analyses were available for 225 subjects. Plasma total, cis-, and trans-β-carotene were significantly lower in PE (73 mcg/L) compared to NT (170 mcg/L), CH (194 mcg/L), and GH (190 mcg/L) groups. Lutein + zeaxanthin and β-cryptoxanthin were also reduced in PE (142 mcg/L and 81 mcg/L) compared to NT (209 mcg/L and 123 mcg/L) but only β-cryptoxanthin was lower in PE compared to GH (126 mcg/L). Levels of α-carotene were lower in PE (18 mcg/L) compared to both CH (43 mcg/L) and GH (48 mcg/L). <b>Conclusions</b>: These results demonstrate that plasma carotenoid levels differ among HDP and may suggest that oxidative stress in PE depletes circulating carotenoids, differentiating it from other HDP.