The role of oxidative stress and antioxidant approaches in preeclampsia: A narrative review

Preeclampsia (PE) is a potentially life-threatening pregnancy complication characterized by new-onset hypertension and proteinuria. Although multiple risk factors have been associated with its development, the underlying etiology remains incompletely understood. Among the mechanisms most strongly linked to hypertensive disorders of pregnancy, oxidative stress (OS) has emerged as a central contributor. Excessive production of reactive oxygen species (ROS) contributes to DNA damage, apoptosis, endothelial dysfunction, increased release of pro-inflammatory cytokines, and impaired anti-inflammatory responses. This narrative review summarizes current evidence regarding the role of OS in the pathophysiology of PE and explores the potential impact of antioxidant-based strategies for its prevention and management. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science, published in English, up to December 2025. Priority was given to clinical studies involving women with PE, particularly those evaluating antioxidant supplementation or related therapeutic interventions. Although it remains unclear whether OS represents a primary cause or secondary consequence of PE, accumulating evidence suggests that reduced antioxidant capacity and increased OS markers contribute to disease development and progression. Studies evaluating antioxidant-based interventions report biologically relevant effects; however, clinical outcomes remain heterogeneous. Overall, OS appears to play a key role in PE, highlighting the need for well-designed longitudinal and interventional studies to clarify causality and define the true therapeutic value of targeting redox pathways.