Preeclampsia

CONCLUSIONS: This protocol summarises the MOMI study design, sample and data collection methods, data harmonisation, and the various analytics platforms, and discusses potential outcomes for enhanced clinical care and novel diagnostic and therapeutic tools.

CONCLUSIONS: Excessive gestational weight gain appears to increase the risk of developing preeclampsia. Pre-pregnancy overweight and obesity increase the risk of excessive gestational weight gain as well as blood pressure and the incidence of preeclampsia. In pregnancy, weight appears to have a positive linear relationship with blood pressure.

CONCLUSIONS: Apart from small for gestational age, maternal asthma itself is not associated with a higher risk of pregnancy complications and adverse perinatal outcomes. However, asthma exacerbations and uncontrolled asthma during pregnancy increase the risk of pre-eclampsia.

CONCLUSION: Lower placental 25(OH)D concentration is associated with an increased placental necroptosis activity in preeclampsia.

CONCLUSIONS: Pregnancy following sleeve gastrectomy carries increased SGA risk, possibly due to unrecognised hypoglycaemia and/or nutrient deficiency. These pregnancies require additional patient education, nutrient monitoring and supplementation, and fetal surveillance.

CONCLUSION: A history of GDM is independently associated with increased HDP in a subsequent pregnancy only when GDM recurs, particularly among high-risk women. In contrast, a history of GDM without recurrence showed no significant association with s-HDP. The PE association was strongest in women with long interpregnancy intervals.

This systematic review synthesizes current evidence on metabolomics-based biomarkers for the early prediction or diagnosis of preeclampsia and highlights promising candidates with potential clinical application. Following PRISMA guidelines, a comprehensive search was performed in PubMed, Cochrane Library, Web of Science, and ClinicalTrials.gov up to September 2024, using predefined terms related to preeclampsia, metabolomics, and pregnancy. Study selection and risk of bias assessment were...

Normal pregnancy is associated with uterine and vascular remodeling by matrix metalloproteinases (MMPs) to facilitate placental blood flow and uterine expansion for the growing fetus. Increases in MMP-2 and MMP-9 in response to estrogen and progesterone promote placentation, uteroplacental vascularization and fetal growth during healthy pregnancy, but are altered in preeclampsia (PE). PE is characterized by hypertension in pregnancy (HTN-Preg) and fetal growth restriction (FGR). Predisposing...

Preeclampsia is a double-hit vascular disorder centred on the VEGF-HO-1-CSE axis. First, excess placental soluble Flt-1 (sFlt-1) neutralises vascular endothelial growth factor (VEGF) and placental growth factor (PlGF), producing an angiogenic deficit that drives endothelial dysfunction, hypertension, proteinuria and end organ injury. Second, the failure of endogenous vascular brakes, heme oxygenase-1 (HO-1/CO) and cystathionine-γ-lyase (CSE)/hydrogen sulfide (H(2)S) removes physiological...

A revised two-stage model of preeclampsia is proposed, centering on an autophagy-dependent requirement for extravillous trophoblast entry into the proximal one-third of the myometrium. The One-Third Myometrium Enigma, introduced here, denotes the unresolved physiological rule that early placentation requires trophoblasts to traverse decidua and reach the proximal one-third of myometrium under hypoxia and nutrient scarcity. The hypothesis posits a timed rise in basal autophagy to sustain...

The aim of this review is to examine the contribution of genomic variation to preeclampsia susceptibility in Africans. PubMed/Medline, Scopus, African Index Medicus and Sabinet African Journals databases were used to access studies conducted in populations of African descent focussing on the genomics of preeclampsia. Studies were selected according to PRISMA guidelines and assessed for quality and risk of bias using the Critical Appraisal Skills Programme (CASP) and Joanna Briggs Institute (JBI)...

Background/Objectives: Preeclampsia represents a significant obstetric complication, frequently linked to elevated levels of perinatal morbidity. This review sought to systematically examine the existing literature regarding associations between telomere length in maternal blood, placental tissue, and umbilical cord blood, and the occurrence of preeclampsia. Methods: A comprehensive search of PubMed/MEDLINE and ScienceDirect was conducted to identify studies published up to January 2025 that...

Preeclampsia (PE) poses risks to mothers and infants, especially in low-resource settings. Diagnosis of PE is difficult due to nonspecific symptoms and limited biomarker screening. ELABELA, a circulating peptide hormone and endogenous ligand of the apelin receptor (APJ), has emerged as a promising biomarker for earlier detection of PE, alone or in combination with other biomarkers. Here, we present β-hairpin protein epitope mimetics (BH-PEMs) as a tool for ELABELA detection. Employing an epitope...

CONCLUSION: The second-trimester sFlt-1/PlGF ratio is an independent predictor for CANO in PE. A model incorporating this biomarker facilitates the early identification of high-risk neonates, informing personalized perinatal management.

CONCLUSION: In this single MCDA twin pregnancy complicated by severe EOPE and concurrent immune-activation markers, initiation of a pregnancy-compatible immunomodulatory regimen was temporally associated with maternal clinical stabilization and a 3-4-week interval to delivery for fetal indications. Controlled studies with validated phenotyping, serial biomarkers (including sFlt-1/PlGF), standardized endpoints, and detailed safety follow-up are needed before attributing benefit or recommending...

CONCLUSIONS: HTRA1, GBA1, KL, and PC may serve as diagnostic biomarkers for PE, potentially influencing M1 polarization of placental macrophages via metabolic reprogramming.

CONCLUSIONS AND RELEVANCE: Humoral autoimmunity plays a significant role in the pathophysiology of PE, offering novel diagnostic and potential therapeutic avenues. Emerging treatments targeting these pathways show promise in alleviating PE symptoms. Further research into autoantibody mechanisms and targeted interventions is essential for improving outcomes in PE-affected pregnancies.

CONCLUSION: These findings demonstrate that PMSC-Exos promote vascular endothelial cell migration and angiogenesis through the THBS4/integrin α2/PI3K/AKT axis, leading to improved pregnancy outcomes in a rat model of PE. THBS4 may serve as a key therapeutic target for preeclampsia. This proof-of-concept study supports the therapeutic potential of PMSC-Exos, pending further translational research.

CONCLUSION: sFLT1 is central to the pathophysiology of preeclampsia and has substantial clinical relevance as both a biomarker and a potential therapeutic target. The sFLT1/PlGF ratio is reshaping risk assessment and management of preeclampsia, while sFLT1-directed therapies may offer future disease-modifying treatment options. Further refinement of biomarker-guided use and therapeutic development is needed before broader implementation.

PURPOSE: Adverse pregnancy and perinatal outcomes (APPOs), including pre-term birth, pre-eclampsia and gestational diabetes, can result in maternal and neonatal morbidity and mortality, parental anxiety and increased healthcare costs. A better understanding of the causes of APPOs is essential to inform lifestyle and pharmaceutical interventions for their prevention and management. Given the difficulty of undertaking randomised controlled trials in pregnant women, triangulating evidence from...

CONCLUSION: In patients with preeclampsia, miR-210 may be involved in the proliferation and apoptosis of human placental trophoblast cells, which may be associated with the JAK2-STAT3 pathway and inflammatory responses. Further studies are warranted to clarify the precise molecular mechanisms underlying these associations.

CONCLUSIONS: Children exposed to PE in utero demonstrate subclinical alterations in left ventricular systolic and diastolic function, detectable only via advanced echocardiographic methods. Conventional echocardiographic parameters may fail to detect these early functional impairments. Long-term cardiac monitoring using 2D-STE could be crucial for this at-risk population, regardless of PE onset timing.

Preeclampsia (PE), a pregnancy-specific disorder characterized by hypertension and placental dysfunction, remains a leading cause of maternal and fetal morbidities worldwide. Recent advances in nanomedicine offer promising therapeutic strategies by targeting placental pathologies. Studies have demonstrated that in PE mouse models, the regulation of key disease-related genes (such as sFlt1 and VEGF) using siRNA- or mRNA-loaded carriers (eg, lipid nanoparticles, exosomes, or elastin-like...

Preeclampsia is a maternal syndrome of placental origin that complicates 2–5% of pregnancies. It remains one of the leading causes of maternal mortality worldwide and is a major contributor to fetal and neonatal morbidity and mortality. It is classically defined, after 20 weeks of gestation, by the combination of arterial hypertension and proteinuria ≥ 0.3 g/24 h. In its severe form, it may induce endothelial injury consistent with thrombotic microangiopathy in the liver and kidneys and can lead...

CONCLUSION: The statistical analysis of the study population aimed to establish a clear difference between the two groups, thereby providing a dependable foundation to differentiate impending preeclampsia from a normal pregnancy in order to assist in theranostics.

Severe preeclampsia (sPE)-induced postpartum hypertensive emergencies (PHEs) pose a threat to maternal safety, requiring rapid and stable blood pressure (BP) control. This protocol describes an observational, non-randomized controlled cohort study designed to evaluate the efficacy and safety of two calcium channel blockers-nicardipine (NIC) and nifedipine (NIF)-in patients with sPE-induced PHEs. Key procedural steps include: retrospective enrollment of 131 eligible patients (67 in the NIC group,...

Preeclampsia involves an angiogenic imbalance, but circulating vascular endothelial growth factor A (VEGF A) remains inconsistently described, particularly in relation to maternal adiposity. We studied 90 second-trimester pregnancies, 30 uncomplicated and 60 with preeclampsia, recording maternal body mass index (BMI) and gestational age at sampling. Serum soluble fms-like tyrosine kinase 1 (sFlt1), placental growth factor (PlGF), and VEGF A were measured by enzyme-linked immunosorbent assay...

INTRODUCTION: Preeclampsia (PE), a severe hypertensive disorder of pregnancy, is associated with circadian rhythm disruption, but the underlying placental molecular networks remain poorly understood. This study aimed to identify key hub genes, regulatory pathways, and novel biomarkers at the intersection of Early-Onset PE (EOPE) and the placental circadian clock.

ObjectiveTo examine whether first-trimester PAPP-A, free β-hCG, NLR, and PLR are associated with subsequent development of PE, and among women with PE, whether these biomarkers are associated with adverse perinatal outcomes.MethodsIn this retrospective case-control study, we analyzed 350 primigravid women, including 175 with PE (cases) and 175 with uncomplicated pregnancies (controls). All participants had singleton gestations and available first-trimester (11 + 0 to 13 + 6 weeks) serum...

Hypertensive disorders of pregnancy (HDP) are common and clinically consequential, affecting ~5%-10% of pregnancies and contributing substantially to maternal and perinatal morbidity and mortality. This review summarizes key concepts that inform bedside decision-making, including contemporary classification, major pathophysiologic pathways (placental dysfunction, endothelial injury, and systemic inflammation), and diagnostic criteria to support timely recognition and risk stratification....

CONCLUSION: SNHG1 regulates trophoblast function through the SNHG1/PTBP1/NGFR axis, contributing to PE pathogenesis. The results provide novel theoretical insights and potential therapeutic targets for PE treatment.

CONCLUSION: These MR findings support a protective association of higher PW with PE/E risk and are consistent with a partial contribution of very large HDL lipid pathways. Given the assumptions of MR mediation and the possibility of overlapping metabolic pathways, these results should be interpreted as evidence consistent with mediation rather than definitive mechanistic proof.

CONCLUSIONS: Pravastatin restored endothelium-dependent relaxation in uterine radial arteries from PE pregnancies. Data support the therapeutic potential for pravastatin in treating PE, with ongoing trials determining the validity of its use in the clinical setting.

Preeclampsia (PE) is a life-threatening obstetric complication, and DNA methylation and immune system disorders play a key role in its development. This study aimed to explore the potential mechanisms and values of abnormally methylated immune-related differentially expressed genes (DEGs) in PE. Gene expression profiles and methylation data of PE were downloaded from the Gene Expression Omnibus (GEO) database. Immune-related genes were downloaded from the ImmPort database. Subsequently,...

Neutrophil extracellular traps (NETs) are considered as a potential mechanism contributing to inflammation in pregnancy complications. To date, no "gold standard" for NET quantification has been established. The content of NETs varies depending on the detection method. The level of NETs and their components in pregnant women with preeclampsia was assessed using cytological and immunofluorescence methods, ELISA, and flow cytometry. All applied methods showed significantly elevated levels of both...

CONCLUSIONS: Retroelements contribute to the structural and expression evolution of PSG genes, facilitating lineage-specific placental evolution. The LTR8B/PSG9 regulatory network plays a central role in syncytiotrophoblast differentiation. Given the association between DLX5/GATA3 dysregulation and elevated PSG9 levels, along with PSG9's expression in the first trimester, PSG9 shows potential as a predictive biomarker for preeclampsia.

INTRODUCTION: Preeclampsia (PE) is a pregnancy-related disorder that contributes to substantial maternal and fetal mortality when accompanied by severe clinical manifestations. Previous studies have reported that endothelial progenitor cells (EPCs) play an important role in regulating vascular homeostasis in PE. However, the relationship between Piezo1 and glycolysis in EPCs during vascular repair in PE remains poorly understood.

CONCLUSION: Our findings identified a novel candidate enhancer of GDF15, with the rs888663 T allele leading to increased enhancer activity, and suggest that GDF15 SNPs affect GDF15 levels in PE or GH.

CONCLUSIONS AND RELEVANCE: In this retrospective, multisite cohort study of pregnancies in late gestation, dynamic short-term prediction of preeclampsia was feasible using routinely available clinical and laboratory data. These results suggest that this approach provided opportunities for earlier intervention and would be adaptable across diverse health care settings.

CONCLUSION: Approximately half of the women with chronic hypertension developed superimposed preeclampsia. MAP ≥ 100 mmHg, the requirement of two or more antihypertensive agents, and a history of previous preeclampsia might be useful tools for predicting superimposed preeclampsia.

Adverse perinatal outcomes of preterm birth (PB), premature rupture of membranes (PROM), intrauterine growth restriction (IUGR), and preeclampsia contribute to a growing number of maternal and fetal deaths each year. Altered immunological regulation of the maternal innate and adaptive immune systems has been implicated in the pathological inflammation dictating obstetrical complications, but the pathogenesis of aberrant maternal immune activation has not been fully elucidated. Microbial...

CONCLUSION: There was a critical gap in accurate knowledge and awareness of pre-eclampsia among women in Mbale City. Misconceptions and reliance on traditional remedies contribute to delayed care-seeking. Targeted, culturally appropriate educational interventions are urgently needed to improve early recognition, promote biomedical care, and enhance maternal and newborn outcomes.

BACKGROUND: With the rapid development of biomedicine in recent years, research on pre-eclampsia and exosomes has received increasing attention; however, no bibliometric analysis of this field has been published.

CONCLUSIONS: Women using ADHD medications had an elevated incidence of cardiometabolic conditions during pregnancy, but it remains unclear to what extent this is attributable to medications rather than the underlying ADHD.

CONCLUSION: Reduced STB-GCX levels are likely associated with placental malperfusion and the severity of LOPE.

Objective: To investigate the maternal and neonatal outcomes of women with a history of pre-eclampsia (PE) and the risk factors for recurrence. Methods: A total of 176 singleton pregnant women with a history of PE who received regular prenatal examination and hospitalized for delivery in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2020 to December 2024 were collected. According to the pregnancy outcome, they were divided into normal pregnancy group (92...

CONCLUSIONS: PWD and QTc-d were identified as independent ECG risk factors for preeclampsia. Monitoring these parameters may help screen high-risk pregnant women and improve the management of those with a history of gestational hypertension or preeclampsia.

Signal transducer and activator of transcription (STAT) proteins are essential DNA-binding proteins that not only facilitate signal transduction but also play a critical role in regulating gene transcription, making them vital for cellular communication and response. Considering the role of this protein in biological processes such as proliferation, differentiation, and inflammation, its significance in the reproductive system, particularly during pregnancy, is undeniable. STAT signaling is...

CONCLUSION: These findings support its potential as an adjunctive therapy to modulate the inflammatory profile in women with preeclampsia, particularly in those with EOPE disease.

This study aims to evaluate the association between the timing of low-dose aspirin (LDA) initiation in the first trimester and obstetric outcomes, including uterine artery pulsatility index (UtA PI), fetal growth parameters, pregnancy-associated plasma protein-A (PAPP-A) levels, and delivery outcomes in a high-risk population for preeclampsia (PE). This prospective cohort study compared pregnant women at high risk for PE who initiated LDA before 11 weeks of gestation (early aspirin group) with...