JMIR Publications

ABSTRACT

Background:

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-OHdG and 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 Moringa oleifera, a locally available plant rich in antioxidants and chelating compounds, has demonstrated protective effects against Hg, Pb, and Cd toxicity in experimental studies. However, intervention studies on pregnant women remain scarce.

Objective:

This study protocol aims to evaluate the effect of Moringa Oleifera supplementation in reducing heavy metal toxicity and oxidative stress biomarkers, 8-hydroxy-2'-deoxyguanosine (8-OHdG) and malondialdehyde (MDA), in pregnant women exposed to high levels of heavy metals.

Methods:

A quasi-experimental, non-randomized 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 Moringa Oleifera supplementation for two 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 ANCOVA, will be used to adjust for baseline differences between the groups.

Results:

A total of 26 mothers for each group have participated. As February 2025 the laboratory analysis have been on going and the result is expected to be published in 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 Moringa oleifera in detoxifying heavy metals and reducing oxidative stress.This study will contribute to the understanding of Moringa Oleifera as a preventive intervention for pregnant women in regions with high environmental exposure to heavy metals, offering a natural, scalable public health solution to improve maternal and fetal health outcomes

Conclusions:

This study will contribute to the understanding of Moringa Oleifera as a preventive intervention for pregnant women in regions with high environmental exposure to heavy metals, offering a natural, scalable public health solution to improve maternal and fetal health outcomes. Clinical Trial: ANZCTR.org.au ACTRN12625000162415