Preeclampsia

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: 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.

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...

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...

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...

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...

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.

CONCLUSIONS: This meta-analysis demonstrated that hydroxychloroquine administration during pregnancy could not reduce the incidence of gestational complications. The results are inconsistent with those of previous primary studies, which may be attributed to the absence of parity-based stratification in the original studies. Accordingly, close attention should be paid to the adverse reactions of hydroxychloroquine, which should be used carefully. Further high-quality studies with subgroup...

Eclampsia is a life-threatening complication of pre-eclampsia, yet remains difficult to predict. In this Perspective, Alice Beardmore-Gray and Andrew Shennan highlight a recent study that identifies 10 novel prodromal symptoms of eclampsia, with potential to better predict which women are at risk and therefore reduce delays in intervention.

This study investigated the risk factors and adverse perinatal outcomes of severe preeclampsia complicated with HELLP (Hemolysis, Elevated Liver Enzymes, and Low Platelet Count syndrome). A total of 170 patients with severe preeclampsia and 30 healthy pregnant women admitted to Wuxi Maternal and Child Health Hospital from January 2020 to October 2023 were enrolled. Of the 170 patients, 30 were complicated by HELLP syndrome and 140 were not; 30 healthy women served as controls. Clinical data,...

CONCLUSIONS: This is the first direct, meta-analytic comparison of sP-selectin and CD62P in preeclampsia. Our original data synthesis confirms CD62P as a stronger biomarker in both diagnostic and predictive contexts. Where flow cytometry is available, CD62P should be preferred. sP-selectin remains useful as an early rule-out tool in screening protocols.

CONCLUSIONS: The ERα-ACSL4 axis plays a critical role in hypoxia-induced ferroptosis in placental trophoblasts. ERα transcriptionally activates ACSL4, promoting lipid peroxidation and ferroptosis, thereby contributing to placental dysfunction in PE. These findings provide a novel theoretical basis for understanding PE pathogenesis and highlight potential therapeutic targets for intervention.

CONCLUSIONS: Third-trimester flare-ups were seen more often among pregnant women with lupus nephritis, and they were more likely to have pre-eclampsia/eclampsia and preterm birth.

RATIONALE: Hypertensive disorders in pregnancy are significant contributors to maternal and perinatal morbidity and mortality. They include chronic hypertension, gestational hypertension and pre-eclampsia. Definitive management of these disorders is planned early birth. The alternative is expectant management with close monitoring, if severe complications are not present. There are benefits and risks associated with both policies, so it is important to establish the safest option.

Immune-related inflammation is linked to preeclampsia (PE), but immune cell-PE associations remain inconsistent. This study used two-sample Mendelian randomization (MR) to explore causal links between immune cell profiles and PE, informing clinical research and interventions. Genome-wide association study data included 731 immune cell phenotypes (3757 Europeans) and PE (2355 cases/264,887 controls, European descent). Single nucleotide polymorphisms were selected as instrumental variables (IVs)...

CONCLUSIONS: Pre-pregnancy obesity is a high-risk factor for pre-eclampsia, whereas an independent association with excessive gestational weight gain was not demonstrated in this cohort. Controlling pre-pregnancy obesity remains a key focus in obstetrics.

CONCLUSION: This study found an increased risk of cardiovascular complications in ARDs patients during hospitalization for delivery. They also had longer hospital stays and higher hospitalization costs.

Preeclampsia (PE) is a complication of pregnancy with high morbidity and mortality, characterized by endothelial dysfunction, systemic inflammation, and impaired renal function. Interleukin-6 (IL-6) and serum creatinine have potential as biomarkers for early detection of PE; however, data from Indonesia are limited. The aim of this study was to compare IL-6 and serum creatinine levels between pregnant women with PE and normotensive controls, as well as their diagnostic performance in identifying...

Preeclampsia (PE) causes approximately 15% of maternal deaths globally, with disproportionately high mortality in low- and middle-income countries. Current diagnostic protocols require laboratory infrastructure and trained personnel, excluding women in resource-limited settings. We developed a smartphone-integrated dual-biomarker lateral flow assay (LFA) platform for simultaneous quantification of nephrin (NPHS1) and podocalyxin (PODXL), two podocyturia-associated biomarkers with established...

CONCLUSION: This study showed that a dietary imbalance in specific AAs represents a modifiable risk factor for PE. This finding, alongside an altered serum AA profile, opens new avenues for targeted nutritional interventions in high-risk pregnancies.

Preeclampsia, a common hypertensive pregnancy disorder associated with shallow trophoblast invasion, is a leading cause of perinatal and maternal mortality worldwide. Many studies have indicated that genes are differentially expressed between normal and diseased states. This study found that SUZ RNA binding domain containing 1 (SZRD1) expression was increased in placenta from preeclamptic pregnancies. However, the role and mechanism of SZRD1 in patients with preeclampsia are unclear. Gene...

Inflammation is a physiological and tightly regulated component of normal pregnancy, contributing to implantation, placental development, and the initiation of parturition. The placenta functions as an active immunological hub, coordinating innate and adaptive immune responses to maintain tolerance while protecting against infection. Preeclampsia and fetal growth restriction (FGR) are major causes of maternal and perinatal morbidity worldwide and represent central manifestations of placental...

Pre-eclampsia and foetal growth restriction (FGR) are major pregnancy complications primarily driven by placental dysfunction, and remain leading causes of maternal and perinatal morbidity. Ultrasound imaging, Doppler studies, and angiogenic biomarkers like placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) constitute the main diagnostic modalities; however, these predominantly reflect established disease rather than early molecular disturbances underlying...

Obstetrical diseases are complications associated with pregnancy or childbirth that can cause maternal sequelae and fetal complications. Among them, preeclampsia (PE) and preterm labor (PTL) are major causes of premature birth and are associated with an increased risk of cerebral palsy, developmental delay, and hearing impairment in infants. However, reliable diagnostic markers and therapeutic strategies for obstetrical diseases remain limited. The aim of this study was to investigate genes...

CONCLUSION: Presence of peritoneal ascites in severe PE is associated with worse maternal and neonatal outcomes, including increased transfusion requirement and adverse perinatal indicators. Detection of ascites may serve as an important clinical marker of disease severity, highlighting the need for closer surveillance and timely intervention.

Pregnancies resulting from assisted reproductive technologies are associated with an increased risk of developing preeclampsia. Available data indicate that one of the risk factors is frozen embryo transfer in an artificial cycle. Assessment of the pulsatility index of the uterine artery along with maternal factors and serum biomarkers form the basis for preeclampsia screening in the 1st trimester. Current evidence suggests that the method of endometrial preparation for embryo transfer may...

CONCLUSIONS: The onset of preeclampsia before 20 weeks should raise suspicion of GTD. Timely, multidisciplinary management can achieve full disease resolution, preserve fertility, and avoid long-term sequelae, even in advanced clinical scenarios.

Fetal growth restriction (FGR) and preeclampsia (PE) are associated with placental insufficiency. Although FGR increases the risk of postnatal intestinal disorders, the mechanisms by which intrauterine stress causes these disorders and the intestinal alterations underlying their pathogenesis remain unclear. In this study, we investigated the underlying molecular mechanisms and potential preventive strategies. Pregnant mice were administered angiotensin II or recombinant soluble fms-like tyrosine...

CONCLUSIONS: The occurrence of placental abruption in preeclampsia significantly impacts neonatal well-being. Close monitoring of blood pressure, particularly systolic blood pressure, urine protein, platelet counts, and visual acuity is crucial for preeclamptic women to early identify the occurrence of placental abruption.

Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of organ damage, after the 20th week of pregnancy. Children born to mothers with preeclampsia or eclampsia (new-onset seizures during pregnancy) are more likely to develop learning and memory deficits and are more susceptible to neurovascular diseases compared with those born from normal pregnancies. The contributing mechanisms are unknown. In this study, we assessed whether exposure to reduced uteroplacental...

CONCLUSION: Evidence on the relationship between LDA use and anaemia in pregnancy remains limited and inconclusive. Available studies lack standardised haematologic endpoints, and LMIC-specific data are sparse.Contribution: This review highlights critical evidence gaps and underscores the need for well-designed prospective studies incorporating standardised anaemia-related outcomes in pregnant populations, particularly in LMIC contexts.

CONCLUSION: Spot PCR is a reliable test for quantifying proteinuria in all pregnant women, as the results were similar to that of a 24-h urine proteinuria test regardless of their HIV status. This shows that the spot PCR yields accurate results. The 24-hour test is inconvenient for pregnant women with and without HIV and is also expensive and time-consuming.Contribution: The UPCR can be introduced as an additional gold standard of PE analysis, especially in outpatients.

Preeclampsia (PE) is associated with systemic oxidative stress and vascular dysfunction, yet its effects on red blood cell (RBC) stability and mechanics remain incompletely understood. Here, we investigate the structural and nanomechanical alterations of RBCs in third-trimester pregnancies complicated by non-severe and severe PE, compared with normotensive controls. RBCs are analyzed using differential scanning calorimetry (DSC) to assess protein thermal stability and atomic force microscopy...

Offspring of preeclamptic (PE) mothers are at increased risk of end-organ damage. Given the widespread use of NSAIDs during pregnancy and their reported ability to mitigate organ damage in PE mothers, this study examined whether prenatal naproxen modifies PE-induced lung injury in male and female offspring. PE was induced by orally administered L-nitro-arginine-methyl ester (L-NAME, 50 mg/kg/day for 7 days) to mothers prior to labor, and lung tissues were excised from 3-month-old offspring....

CONCLUSIONS: These findings support the potential role of the eNOS VNTR 4a/4b polymorphism in both the risk and severity of preeclampsia in the Algerian population.

Preeclampsia remains a major cause of maternal and perinatal morbidity and mortality worldwide, yet progress in biomarker discovery and predictive modeling has translated only modestly into clinically meaningful risk stratification. Over the past two decades, numerous biomarkers and predictors reflecting placental-angiogenic dysfunction, maternal cardiovascular maladaptation, and inflammatory-metabolic stress have been proposed, alongside increasingly sophisticated statistical and machine...

Preeclampsia (PE) is a complex hypertensive disorder of pregnancy characterized by new-onset maternal hypertension and multi-organ dysfunction. Although placental maladaptation and immune activation are well-established features of PE, growing evidence indicates that dysregulated neuro-immune-vascular integration critically contributes to disease initiation, progression, and long-term sequelae. Normal pregnancy requires coordinated immune and neural adaptations, particularly at the...

BACKGROUND: Gestational diabetes mellitus (GDM) is a significant complication during pregnancy with varying prevalence across countries and ethnicities. In Taiwan, although GDM prevalence rose from 7.6% to 13.4% between 2004 and 2015, its maternal gestational and extended consequences remained underexamined. The nationwide population-based study aims to investigate GDM-related risk factors and identify the critical period during which GDM likely poses long-term health risks.

Intrahepatic cholestasis of pregnancy (IHCP) is the most common pregnancy-specific liver disease. This study aimed to determine the prevalence of proteinuria in patients with IHCP and to evaluate its association with adverse pregnancy outcomes. This retrospective cohort study included pregnant patients with gestational age > 24 weeks who were diagnosed with IHCP and completed 24-hour urine protein collection at Haseki Training and Research Hospital (January 2018-December 2024). Proteinuria was...

CONCLUSION: Preeclampsia is characterized by measurable extracellular fluid expansion on bedside BIA. Elevated ECW/TBW is associated with adverse perinatal outcomes among hospitalized high-risk pregnancies, supporting the potential clinical utility of non-invasive fluid assessment for risk stratification in hypertensive disorders of pregnancy.

CONCLUSIONS: Pregnancy-associated PRES and RCVS are potentially life-threatening, rare conditions that can result in hemorrhagic stroke. PRES ± RCVS is strongly associated with preeclampsia with severe features, whereas puerperal RCVS seems to be a separate, later-occurring condition.

CONCLUSION: SPP1 is a central paracrine mediator of trophoblast-endothelial crosstalk, and its hypoxia-induced reduced expression drives vascular dysfunction in PE via the integrin αVβ3-PI3K/Akt-MMP-9/TIMP-1 axis. Our findings nominate SPP1 as both a promising biomarker and a potential therapeutic target for PE.

CONCLUSIONS AND RELEVANCE: In this cohort study, pregestationally assessed cardiometabolic biomarkers were associated with increased risk of HDP in nulliparous women. For some biomarkers, the increased risk was observed below standard cutoff levels for a clinical diagnosis, that is, at subclinical levels. These results suggest that assessment of cardiometabolic biomarkers may improve identification of women at risk of HDP, both in preconceptional counseling settings and at enrollment in...

CONCLUSION: Longer IPI was independently associated with a modest increase in the risk of HDP, particularly among women without prior HDP. No significant association was observed for preeclampsia, suggesting that IPI may primarily influence the broader HDP phenotype rather than specific subtypes. These findings support the consideration of IPI in preconception counseling, with an emphasis on individualized risk assessment.