{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:00:49Z","timestamp":1782846049116,"version":"3.54.5"},"reference-count":46,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Res Protoc"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Heavy metals present in the environment, including lead, cadmium, and mercury, pose significant health risks to pregnant women and fetal development through food, water, and air contamination. Exposure to these metals has been linked to miscarriage, low birth weight (LBW), preterm birth, and developmental issues in children. The mechanism of oxidative stress, characterized by increased 8-hydroxy-2\u2019-deoxyguanosine (8-OHdG) and malondialdehyde (MDA) levels, contributes to DNA damage, genomic instability, and adverse pregnancy outcomes. Additionally, DNA methylation changes induced by metal exposure may further exacerbate these risks. Certain micronutrients play a crucial role in heavy metal detoxification, and\n Moringa oleifera<\/jats:italic>\n , a locally available plant rich in antioxidants and chelating compounds\n ,<\/jats:bold>\n has demonstrated protective effects against mercury (Hg), lead (Pb), and cadmium (Cd) toxicity in experimental studies. However, intervention studies on pregnant women remain scarce.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n The objective of this study was to evaluate the effect of\n M. oleifera<\/jats:italic>\n supplementation in reducing heavy metal toxicity and oxidative stress biomarkers, 8-OHdG and MDA, in pregnant women exposed to high levels of heavy metals.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A quasi-experimental, nonrandomized pre-post test design is used. Pregnant women with elevated heavy metal levels, identified through initial screening, will be included in the intervention group, receiving\n M. oleifera<\/jats:italic>\n supplementation for 2 months. The control group will consist of women from similar geographical regions who will not receive the intervention. Primary outcomes will include changes in heavy metal concentrations, measured using inductively coupled plasma mass spectrometry (ICP-MS). Secondary outcomes will focus on reductions in oxidative stress biomarkers, measured via enzyme-linked immunosorbent assay (ELISA). Statistical analyses, including analysis of covariance (ANCOVA), will be used to adjust for baseline differences between the groups.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 26 mothers for each group have participated. As of February 2025, the laboratory analyses have been ongoing, and the result is expected to be published at the end of 2025. The protocol anticipates that the intervention group will show a significant reduction in both heavy metal levels and oxidative stress biomarkers compared to the control group, suggesting the potential efficacy of\n M. oleifera<\/jats:italic>\n in detoxifying heavy metals and reducing oxidative stress.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n This study is expected to provide preliminary evidence on the potential effectiveness and safety of\n M. oleifera<\/jats:italic>\n supplementation for reducing heavy metal toxicity and oxidative stress in pregnant women.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/73201","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T07:05:06Z","timestamp":1756191906000},"page":"e73201-e73201","source":"Crossref","is-referenced-by-count":0,"title":["Moringa oleifera Supplementation for Reducing Heavy Metal Toxicity and Oxidative Stress in Pregnant Women: Protocol for a Nonrandomized Trial Study"],"prefix":"10.2196","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4961-8517","authenticated-orcid":false,"given":"Hasnawati","family":"Amqam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2729-643X","authenticated-orcid":false,"given":"Anna","family":"Khuzaimah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0460-4218","authenticated-orcid":false,"given":"Ulfah","family":"Najamuddin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0798-0457","authenticated-orcid":false,"given":"Mardiana","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0020-6722","authenticated-orcid":false,"given":"Muflihatul","family":"Muniroh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4813-5356","authenticated-orcid":false,"given":"Ancah Caesarina Novi","family":"Marchianti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6863-8647","authenticated-orcid":false,"given":"Saliza","family":"Mohd Elias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2019.01.067","article-title":"Heavy metals in food crops: health risks, fate, mechanisms, and management","volume":"125","author":"Rai","journal-title":"Environ Int"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-7643-8340-4_6","article-title":"Heavy metal toxicity and the environment","volume":"03","author":"Tchounwou","journal-title":"Exp Suppl"},{"key":"R3","unstructured":"World Health Organization. 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