Preeclampsia

Preeclampsia (PE) is a severe pregnancy-specific hypertensive disorder characterized by immune microenvironment dysregulation at the maternal-fetal interface, with decidual macrophage phenotypic imbalance being a key pathological feature. The Ghrelin/growth hormone secretagogue receptor-1a (GHSR-1a) axis exerts immunomodulatory and anti-inflammatory effects, but its role in regulating decidual macrophage infiltration and phenotypic marker expression in PE remains unclear. In this study, we first...

CONCLUSIONS: Hyperuricemia was common among women with preeclampsia in hospital-based LMIC studies. These findings describe prevalence only and should not be interpreted as evidence of diagnostic accuracy, prognostic performance, or clinical utility. Future studies should standardize diagnostic thresholds and report gestational timing of uric acid measurement more consistently.

CONCLUSION: This study highlighted immune-related genetic loci that could function as biomarkers for the early prediction of preeclampsia in Chinese women.

CONCLUSION: USP22 maintains trophoblast survival through selective K48-deubiquitination of KAT2A, which stabilizes KAT2A and sustains histone acetylation at the SFRP1 promoter, thereby promoting SFRP1 transcription and suppressing RIPK1-RIPK3-MLKL-mediated necroptosis. The USP22-KAT2A-SFRP1 axis represents a novel epigenetic checkpoint in PE pathogenesis and a potential therapeutic target for placental insufficiency.

Catastrophic antiphospholipid syndrome (CAPS) is a rare, life-threatening condition with 30% mortality that poses diagnostic challenges during pregnancy due to overlap with preeclampsia and HELLP syndrome. We report a woman in her 30s who developed probable CAPS following emergency cesarean delivery at 22 weeks for severe preeclampsia. Unlike typical CAPS presentations, our patient lacked characteristic cutaneous manifestations, instead presenting with progressive cardiac, pulmonary, and renal...

CONCLUSION: We find little robust evidence for causal effects of age at menarche on pregnancy outcomes. Effects of younger menarche on increased risks of hypertensive disorders of pregnancy may be driven by adiposity.

CONCLUSION: Prior history of preeclampsia, chronic hypertension, and elevated first-trimester mean arterial pressure were key predictors of preeclampsia development. These findings support the importance of first-trimester risk stratification using maternal history and mean arterial pressure measurement to guide early preventive interventions, particularly in settings where biochemical markers are not routinely available.

CONCLUSIONS: Moderate GWG was associated with the lowest risk of PE in twin pregnancies, whereas excessive GWG increased risk. These findings suggest that moderate GWG may be associated with a lower risk of PE in twin pregnancies. Further prospective studies are needed to clarify temporality and optimal GWG ranges in twin gestations.

This study aims to investigate the threshold effect of labor duration on adverse outcomes associated with cesarean sections in pregnant women with gestational hypertension and preeclampsia (GH-PE). This study conducted a retrospective cohort study on 1188 pregnant women who delivered at our hospital from January 1, 2022, to December 31, 2024. The effect of the threshold value of the labor duration for successful vaginal delivery among pregnant women with GH-PE was analyzed through curve fitting....

Preeclampsia (PE) is a major cause of maternal and perinatal morbidity. Because abnormal fat distribution is closely related to metabolic dysfunction, vascular injury, and hypertensive disorders during pregnancy, clarifying its genetic relationship with PE may improve our understanding of adverse pregnancy outcomes. Here, we investigated the shared genetic architecture between PE and waist-hip ratio adjusted for body mass index (WHRadjBMI) by integrating large-scale genome-wide association study...

Preeclampsia is a pregnancy-specific disorder characterized by hypertension and multi-organ dysfunction, originating primarily from placental abnormalities rather than maternal pathology alone. Impaired trophoblast invasion, defective spiral artery remodeling, angiogenic imbalance, oxidative stress, and sterile inflammation collectively drive placental dysfunction and subsequent systemic endothelial injury. Current clinical management remains largely supportive, highlighting the urgent need for...

Preeclampsia (PE) is a major hypertensive disorder of pregnancy, with systemic inflammation being a key component of its pathogenesis. The neutrophil-to-lymphocyte ratio (NLR) has been investigated as an inflammatory biomarker for PE; however, its levels are rarely compared directly to both healthy pregnant and non-pregnant controls. This study aimed to evaluate the role of NLR in PE by comparing its levels across these three distinct groups. This retrospective study analyzed medical records...

Preeclampsia (PE), a hypertensive disorder unique to pregnancy, is linked to impaired trophoblast function. DEAD-box helicase 39B (DDX39B) plays key roles in embryonic development. This study investigated its role in regulating trophoblast biology during PE progression. We conducted functional assays using CCK-8, clone formation, EdU, Transwell, Wound healing and TUNEL in the HTR-8/SVneo trophoblast cells. The interaction between Wilms tumor 1-associating protein (WTAP) and DDX39B was analyzed...

Preeclampsia (PE) is a complication during pregnancy characterized by hypertension, organ damage, and systemic inflammation. Increasing evidence suggests that the gut microbiome may play a role in the pathophysiology of PE. However, previous studies on the gut microbiome have generally overlooked the distinction between subgroups of PE, although clinical manifestations may differ. Also, most studies have not used deep sequencing techniques. Therefore, this study aimed to explore further...

BACKGROUND: Despite significant advancements in obstetric care, the incidence of preeclampsia remains a substantial public health challenge, and effective strategies to prevent the disease progression remain limited, particularly in low-resource settings. N-acetylcysteine (NAC), an antioxidant and glutathione precursor, has demonstrated anti-inflammatory and vasodilatory effects, making it a promising candidate for repurposing. However, robust evidence from well-powered randomized controlled...

CONCLUSIONS: In women with late-onset preeclampsia, circulating NEFA levels were higher in the obese group and were weakly associated with BMI. These findings suggest an association between obesity and circulating NEFA levels within this clinical phenotype. However, due to the cross-sectional design and absence of normotensive control groups, causality and disease specificity cannot be determined. Further studies are needed to clarify the role of NEFA in preeclampsia.

CONCLUSION: This MR study suggests distinct mitochondrial pathways for E and PE, with DECR1 and SerRS associated with E, and ETHE1 and TMEM70 with PE. These preliminary findings suggest non-overlapping genetic underpinnings and highlight the proteins as potential biomarkers for further investigation.

CONCLUSIONS: FAR provides statistically significant incremental prognostic value for predicting CAPO, a composite of severe peripartum events. From an anesthesiology perspective, FAR ≥0.135 alerts to coagulopathy and systemic inflammation, supporting cautious neuraxial anesthesia, early invasive monitoring, and escalated perioperative care.

CONCLUSIONS: Prepregnancy obesity is more strongly associated with PE/E risk among Asian/PI and White individuals than Black individuals, suggesting differing underlying mechanisms. These findings can inform refined risk stratification and call for further research into the biological and structural drivers of racial and ethnic disparities in PE/E.

Preeclampsia (PE) is a major pregnancy-specific disorder driven by impaired trophoblast function, placental hypoxia, and excessive oxidative stress. Ferroptosis has recently emerged as a key contributor to placental pathology; however, the upstream regulatory mechanisms that activate ferroptosis in trophoblasts remain incompletely defined. Circular RNAs (circRNAs) have been implicated in trophoblast dysfunction, yet the ferroptosis-related circRNA network in PE is largely unexplored. This study...

Preeclampsia is increasingly understood not only as a clinical syndrome of hypertension and organ dysfunction, but also as a disorder in which placental gene regulation, maternal vascular adaptation, and inflammatory signaling are shaped by abnormal epigenetic control. While several reviews have described epigenetic biomarkers in preeclampsia, the therapeutic implications of these mechanisms remain less clearly integrated. This review, therefore, focuses on the translational potential of...

CONCLUSIONS: Improving the quality and delivery of information for women and their support networks can reduce the strain on personal resources and make this essential preventive treatment more accessible and equitable.

CONCLUSION: Significant increases in TSH combined with decreases in FT4 during pregnancy are associated with higher risk of preeclampsia and related complications, even among women with normal thyroid function.

Hypertensive disorders, particularly pre-eclampsia, are major contributors to maternal mortality worldwide. Uterine artery Doppler ultrasonography, which measures indices such as the pulsatility index (PI) and resistance index (RI), has proven to be an effective tool for the early prediction of pre-eclampsia and intrauterine growth restriction (IUGR). This study aimed to evaluate the predictive value of uterine artery Doppler indices between 14-22 weeks of gestation for these adverse pregnancy...

Trophoblasts are multifunctional cells in the placenta and essential for normal pregnancy. Although trophoblast dysfunction can cause pregnancy complications, the underlying mechanisms remain unclear, and effective treatments are limited, partly because of the scarcity of appropriate experimental models. We previously reported the derivation of human trophoblast stem cells (hTSCs) from 1st-trimester placentas and blastocysts, providing a powerful tool to investigate human trophoblast development...

Proper placental angiogenesis is essential for fetal growth and maternal well-being during pregnancy. Imbalance between pro-angiogenic (placental growth factor (PlGF), vascular endothelial growth factor-A (VEGF-A)) and anti-angiogenic (soluble fms-like tyrosine kinase-1 (sFlt-1), soluble endoglin (sEng)) factors underlies preeclampsia (PE), fetal growth restriction (FGR), and related complications. The primary scientific aim of this review is to comprehensively synthesize current evidence on the...

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To compare and rank the benefits and harms of interventions for the prevention of preeclampsia in pregnant women at increased risk who are up to 16+6 weeks of gestation, using network meta-analysis.

CONCLUSION: Early pregnancy hypermethylation of MTNR1A and Fn14, but not MTNR1B, was observed in high-risk and PE women and co-occurred with a significantly reduced sTWEAK level and non-significantly reduced serum melatonin, suggesting epigenetic modulation of antioxidant and angiogenic pathways in women at risk for PE. These findings establish associations rather than causation and require validation using quantitative assays in multicenter cohorts before clinical translation.

CONCLUSIONS: PRS and 2-sample Mendelian randomization approaches suggest enrichment for EC-acting CAD genetic risk variants in women with HDPs. These findings support a shared genetic architecture between HDPs and CAD through endothelial dysfunction.

CONCLUSION: Maternal α1-AGP and PBH are significantly elevated in preeclampsia, with α1-AGP also higher in postnatal umbilical cord blood. The high AUC supports their relevance as biomarkers of maternal and postnatal inflammation in PE.

CONCLUSIONS: This study demonstrated that integrating multimodal data improved the assessment of fetal lung development in GDM and PE. By linking imaging features with molecular and histopathological alterations, the proposed framework provides new methodological and biological insights and suggests a potential non-invasive strategy for monitoring fetal lung development in high-risk pregnancies.

CONCLUSION: Effective implementation of low-dose aspirin and calcium supplementation for preeclampsia prevention will require strengthening antenatal care and provision of services at the primary health care level and enabling the policy environment where needed. Increased coordination around a package of interventions aimed at reducing preeclampsia will also be critical going forward. Practice recommendations on policy, demand, clinical implementation, and monitoring are summarized.

CONCLUSION: Elevated ferritin and decreased Hb levels were independently associated with the development of PE. Se was associated with PE in univariate analysis but did not remain an independent predictor after adjustment, suggesting that it may reflect underlying oxidative stress rather than act as a causal determinant.

CONCLUSION: IVF is independently associated with an increased risk of preeclampsia and preterm birth. Enhanced monitoring and tailored prenatal care are warranted in IVF pregnancies.

Preeclampsia (PE) is a complex hypertensive disorder resulting from placental insufficiency during pregnancy. PE contributes to maternal and fetal morbidity and mortality and often co-occurs with fetal growth restriction (FGR); these two are both considered placental insufficiency syndromes. Alterations in mitochondrial function levels due to placental insufficiency play an important role in the pathophysiology of PE and FGR. Changes in these processes can lead to maternal and fetal organ damage...

Objective Exploring the role of transcription factor EB (TFEB)-mediated nuclear translocation in lysosomal degradation of glutathione peroxidase 4 (GPX4) in ferroptosis of human embryonic trophoblast cells HTR8-S/Vneo. Methods HTR8-S/Vneo cells were divided into the following groups: normal group, hypoxia group, hypoxia+si-NC group (cells transfected with si-NC), hypoxia+si-TFEB group (cells transfected with si-TFEB), hypoxia+si-TFEB+RSL3 group (cells transfected with si-TFEB and treated with...

CONCLUSION: The reliability of preeclampsia information on both Douyin and YouTube was suboptimal and inconsistent. Higher social engagement does not guarantee higher informational quality. These findings underscore the need for users to critically evaluate sources.

INTRODUCTION: Hypertensive disorders of pregnancy, such as pre-eclampsia (PE), are one of the leading causes of maternal and perinatal deaths in low- and middle-income countries (LMICs). Although clinical practice guidelines (CPGs) for PE prevention and management are available, there is limited information on their implementation in LMIC contexts. This realist synthesis therefore aims to uncover the causal explanations underpinning the implementation of CPG recommendations for PE prevention and...

Preeclampsia is a pregnancy-specific multisystem disorder and a major cause of maternal and perinatal morbidity and mortality worldwide. This narrative review summarizes current evidence on the principal risk factors and pathophysiological mechanisms involved in its development. The disease is best explained by the two-stage model: in stage 1, inadequate trophoblast invasion and incomplete spiral artery remodeling lead to placental hypoperfusion, hypoxia, and oxidative stress; in stage 2, the...

Preeclampsia (PE), a gestational disorder diagnosed with hypertension and proteinuria, is recognized as a significant cause of both maternal and perinatal morbidity and mortality around the world. Oxidative stress (OS) is found to act as a major positive role in PE progression, which is regulated by the function derived from multiple microRNAs (miRNAs), a group of cellular small endogenous RNAs that modulate gene expression at post-transcriptional level. This review summarizes the role of...

Trans fatty acids (TFAs), present in certain processed foods and ruminant products, remain a source of dietary exposure despite global reductions in industrial TFAs (iTFAs). Their relevance during pregnancy is of particular interest because the quality and composition of maternal dietary fats can influence placental function, vascular adaptation, and fetal growth. This review was based on the hypothesis that maternal exposure to specific industrial trans-18:1 isomers is associated with increased...

CONCLUSION: This study highlights the impact of climatic factors on the incidence of eclampsia and preeclampsia. A coordinated effort among multi stakeholders is crucial, with policymakers prioritizing the inclusion of localized climate variables in health programs, ensuring effective policy implementation, and preparing healthcare providers for climate-related challenges.

PRESENTATION: A 29-year-old primigravida woman (G1P0) with a BMI of 35.2 presented at 38+3 weeks with severe edema extending from lower abdomen to her thighs, and vulval edema predominantly right-sided, and associated with difficulty mobilizing. Her BP was 160/94 mmHg. She had a prior diagnosis of gestational hypertension that progressed to preeclampsia.

Immunological changes induced by a woman's first pregnancy in controls and in cases of preeclampsia, which is more frequent and often a more severe complication in primigravid women, were investigated. Decidual natural killer (NK) cells are important for placentation and interact with HLA Ib molecules on extravillous trophoblast cells through specific receptors. In a clinical study part, we identified an increase in the CD56brightCD16-ILT2+ NK subpopulation in peripheral blood in multigravid...

BACKGROUND: Several studies have documented increasing rates of obstetric acute kidney injury (AKI) in Canada, particularly among females with preeclampsia. We aimed to quantify recent patterns in obstetric AKI and explore the cause for the rising rates.

CONCLUSIONS: A higher incidence of PE was observed in women who conceived using ART and notable differences in the distribution of preterm and term PE were observed among the ART subgroups. The FMF first-trimester PE screening algorithm showed high DRs across all conception groups. However, differences in screen-positive rates and individual risk marker profiles suggest that the incorporation of ART-subgroup-specific adjustments could improve the predictive performance of the model in ART...

CONCLUSION: CCN5 overexpression may reduce proliferation and EMT in humans trophoblast cells via the ERK/Twist1 pathway. This finding suggests that CCN5 could serves as a viable target in PE treatment.

CONCLUSIONS: This review reveals a significant gap in research examining endometriosis in Black women and its association with adverse pregnancy outcomes, including preeclampsia and eclampsia. The findings emphasize the need for inclusive, race-conscious research to inform clinical care and reduce maternal health disparities.

Preeclampsia (PE) is a hypertensive disorder of pregnancy characterized by endothelial dysfunction, impaired uteroplacental perfusion, and high maternalfetal morbidity. Although modern biomarkers provide early diagnostic potential, few predictive systems connect molecular imbalance to physical flow abnormalities. Using our previous results, we developed a Physics-Informed Digital Twin that simulates uteroplacental hemodynamics under real physiological constraints. The twin integrates mean...

CONCLUSION: Prevalence of mood and anxiety symptoms increased over time, hypertensive disorders of pregnancy were not a contributing factor. Prior mental illness and recent life stressors were key predictors.