Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. Administration of vaginal lactoferrin 4 hours before amniocentesis decreased markers of oxidative stress.

Evidence Rating Level: 2 (Good)

While reactive oxygen species (ROS) are a necessary part of metabolism, excessive ROS can result in a condition, Oxidative Stress, which is associated with many negative pregnancy outcomes such as spontaneous abortion, recurrent miscarriage, preterm labour and preterm pre-labour rupture of membranes. Lactoferrin, a naturally found glycoprotein that has antimicrobial properties, has antioxidant properties due its ability to sequester Fe3+ and anti-inflammatory properties. In this open-label, randomized, single centre pilot study, 60 pregnant patients undergoing amniocentesis at 16 weeks were randomized in a 1:1:1 ratio either receive vaginal lactoferrin 300 mg 4 hours before amniocentesis, vaginal lactoferrin 12 hours before amniocentesis or no treatment (control). A portion of the amniotic fluid sample that was collected was used for analysis. Lactoferrin administration 4 hours before the procedure decreased the concentration of thiobarbituric acid reactive substances (TBARS, as a measure of ROS, p<0.0001), decreased oxidative stress index (OSI) (p<0.0001), and increased total antioxidant status (TAS, 35% higher than control p<0.0001, 17% higher than lactoferrin at 12 hours, p<0.001). Lactoferrin administration 12 hours beforehand was associated with decreased concentration of TBARS but to a lower extent (p<0.05). There was no statistically significant difference for OSI or TAS, possibly owing to the short half-life of lactoferrin. Vaginal lactoferrin administration may have potential as adjuvant in dealing with inflammation-related adverse pregnancy outcomes. Future studies with increased sample size, longitudinal design and viable dosing regimens to sustain longer effects are needed to understand the impact of vaginal lactoferrin on pregnancy-related outcomes.

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