IUGR is a major causes and silent illness and death in the embryonic and infants population, which in it infants growth potential is less than natural state. IUGR phrase and small for gestation age often used interchangeably. Although, there is small difference between these two.IUGR/SGA as a result different etiology including maternal factors, placenta and fetus arise. That recently genetic factors added to it. IUGR may be caused by maternal smoking, infections agents and chromosomal or genetic abnormalities, maternal abnormalities, but in most cases secondary cause is placenta insufficiency. IUGR often causes complications in the third trimester of pregnancy which is associated with symptoms of Preeclampsia.The pathophysiology of IUGR is associated with placenta insufficiency. It remains unclear, but the damage is usually caused due to failure of trophoblast invasion which causes intermittent blood flow the space between the intervillous that this also in turn causes local oxidative stress.

Preeclampsia as a multifactor hypertensive disorder of pregnancy is associated with enhanced placental oxidative stress. The Keap1-Nrf2 pathway protects cells against oxidative stress. We examined the possible association between the Nrf2 variants in relation to oxidative stress parameters with the risk of Preeclampsia. We studied 150 Preeclampsia women and 150 women with a normal pregnancy to find the frequency of Nrf2 rs6721961 genotypes using the PCRRFLP method. Also, an association between the Nrf2 genotypes with the levels of malondialdehyde (MDA) and total antioxidant capacity (TAC) was analyzed. Significantly lower TAC and higher MDA levels were found in Preeclampsia patients compared to controls (P<0. 0001). For the first time, we report an association between the Nrf2 rs6721961 polymorphism and Preeclampsia risk. The present study indicated that the GT genotype and the T allele of the Nrf2 rs6721961 increased the risk of Preeclampsia by 2. 81 and 2. 39 times, respectively. Also, the Nrf2 TT genotype was associated with a 3. 9-fold increased risk of earlyonset Preeclampsia. We detected a positive association between the levels of body mass index, MDA, and the Nrf2 polymorphism with the risk of Preeclampsia and a negative correlation between the level of TAC with the Preeclampsia risk. Also, an association between the rs6721961 TT genotype with higher serum MDA levels was found. Our study suggests oxidative stress is involved in the pathogenesis of Preeclampsia and the Nrf2 rs6721961 polymorphism through alteration in the levels of oxidative stress parameters might increase the risk of Preeclampsia and early-onset Preeclampsia.