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Sporadic studies suggest the significance of deregulated OS in hepatitis E virus (HEV) infected pregnancy, but with limited reactive oxygen species (ROS) or antioxidant markers. The present novel study, therefore, aimed to evaluate the significance of ROS\u2010antioxidant imbalance and resulting altered OS in HEV infected pregnancy complications like preterm delivery (PTD) and outcome. Difference in serum levels of ROS and antioxidant panel of markers were evaluated by ELISA for HEV immunoglobulin M RNA positive genotype 1 cases (including acute [acute viral hepatitis, AVH] and fulminant [fulminant hepatic failure, FHF] cases) and healthy term delivery subjects, and analyzed statistically. Direct ROS marker H<jats:sub>2<\/jats:sub>O<jats:sub>2<\/jats:sub> levels and indirect OS marker for DNA damage 8\u2010hydroxy\u20102\u2032\u2010deoxyguanosine was significantly increased in HEV\u2010cases compared to controls, and was associated and prognostic factor for PTD and fetal death in HEV cases. A comparatively lower total serum antioxidant capacity was observed in the FHF cases compared to the control subjects and the AVH cases. Glutathione (GSH) levels and superoxide dismutase (SOD) activity were significantly associated with PTD in the FHF sub\u2010cohorts (<jats:italic>p<\/jats:italic>\u2009=\u20090.017) and AVH sub\u2010cohorts (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), respectively, and was associated with poor prognosis in HEV cases. The serum H<jats:sub>2<\/jats:sub>O<jats:sub>2<\/jats:sub> levels were found to be negatively correlated with SOD activity (<jats:italic>p<\/jats:italic>\u2009=\u20090.016) and GSH levels (<jats:italic>p<\/jats:italic>\u2009=\u20090.001) in the HEV\u2010AVH cases; and positively correlated with the viral load in HEV cases (<jats:italic>p<\/jats:italic>\u2009=\u20090.023). The ROS\u2010antioxidant imbalance resulting OS plays a detrimental associative role in HEV infected pregnancy complications like PTD and adverse pregnancy outcomes; and holds therapeutic significance.<\/jats:p>","DOI":"10.1002\/jmv.28576","type":"journal-article","created":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T10:19:45Z","timestamp":1676283585000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Oxidative stress\u2014A key determinant of complications and negative outcome in hepatitis E virus infected pregnancies: A comprehensive account involving cases from northeast India"],"prefix":"10.1002","volume":"95","author":[{"given":"Natasha","family":"Kashyap","sequence":"first","affiliation":[{"name":"Department of Molecular Biology and Biotechnology Cotton University Guwahati Assam India"},{"name":"Department of Biotechnology Gauhati University Guwahati Assam India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mafidul","family":"Islam","sequence":"additional","affiliation":[{"name":"Department of Biotechnology Gauhati University Guwahati Assam India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harpreet","family":"Kaur","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Communicable Diseases (ECD) Indian Council of Medical Research Headquarters New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diptika","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Department of Biotechnology Gauhati University Guwahati Assam India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anjuma","family":"Begum","sequence":"additional","affiliation":[{"name":"Department of Biotechnology Gauhati University Guwahati Assam India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moumita","family":"Bose","sequence":"additional","affiliation":[{"name":"Department of Biotechnology Gauhati University Guwahati Assam India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chandana Ray","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Gauhati Medical College &amp; Hospital (GMCH) Guwahati Assam India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anjan Kumar","family":"Saikia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology &amp; Hepatology Guwahati Neurological Research Center (GNRC) Hospitals Guwahati Assam India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pankaj","family":"Kalita","sequence":"additional","affiliation":[{"name":"Department of Ayurveda SMO (Ayurveda), ESIC Model Hospital Guwahati Assam India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Purabi Deka","family":"Bose","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology and Biotechnology Cotton University Guwahati Assam India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sujoy","family":"Bose","sequence":"additional","affiliation":[{"name":"Department of Biotechnology Gauhati University Guwahati Assam India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,2,22]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"185","article-title":"WHO position paper","volume":"18","author":"WHO. 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