p53‑mediated apoptosis as a molecular link between oxidative stress and bad obstetric history

Bad obstetric history (BOH), characterised by recurrent pregnancy loss and other adverse pregnancy outcomes, affects ~5% of women worldwide and often causes significant psychological distress to affected women and their families. Increasing evidence suggests that oxidative stress and dysregulated apoptosis play crucial roles in its pathogenesis. The p53 gene is a key regulator of apoptosis during normal pregnancy; however, its specific involvement in BOH and its association with oxidative stress are not yet clearly understood. Therefore, the present study aimed to assess oxidative stress and apoptotic markers along with p53 gene expression in women with BOH in order to explore their interrelationship. For this purpose, a case‑control study was conducted with 100 BOH cases and 100 healthy controls. Malondialdehyde (MDA) and caspase‑3 levels were measured from serum using ELISA in order to assess oxidative stress and apoptosis, respectively, while p53 gene expression (2^‑ΔΔCq method) was quantified using reverse transcription‑quantitative PCR. Data were analysed for group differences and correlations using Jamovi software. Compared with the controls, women with BOH exhibited significantly elevated MDA (4.1±1.6 vs. 1.9±0.8 nmol/ml), caspase‑3 (3.3±2.3 vs. 1.9±1.0 ng/ml) and p53 gene expression levels (1.4±0.7 vs. 1.0±0.2; all P<0.01). A moderate positive correlation was observed between MDA and p53 (r=0.4584, P<0.01), whereas a strong correlation was observed between caspase‑3 and p53 (r=0.7136, P<0.01). On the whole, the present study demonstrates that oxidative stress and p53‑mediated apoptosis exhibit a significant association with BOH, suggesting their potential relevance in the condition. An enhanced p53 expression and caspase‑3 activity contribute to impaired placental function and pregnancy loss, highlighting p53 as a potential molecular marker for early risk identification.