Fast track — SeriesPathogenesis and genetics of pre-eclampsia
Section snippets
Predisposing factors
Pre-eclampsia, however, requires more than lowered placental perfusion. Other conditions such as intrauterine growth restriction7 and the fact that approximately a third of preterm births9 manifest abnormal modification of the spiral arteries identical to that present in pre-eclampsia, suggest that pre-eclampsia is a two-stage disorder. Numerous maternal factors can predispose to the disorder; these may be genetic, behavioural, or environmental. The list of predisposing factors includes
Oxidative stress
A current hypothesis explaining the endothelial alterations in atherosclerosis invokes oxidative stress as pathogenically important.11 The small dense LDLs which are part of the atherogenic dyslipidaemia are proposed to have preferential access to the subendothelial space, where they bind to proteoglycans and reside longer than other LDLs. Small dense LDL are inherently more easily oxidisable. Protected from circulating antioxidants in the subendothelial space, they form oxidised LDL. Oxidised
Genetic factors
The hypothesis that the cause of eclampsia and preeclampsia is at least partly genetic is broadly suggested by its occurrence in time and space. The earliest record of eclampsia was in the Kahun papyrus from Egypt of 3000 years ago.14 Data on its occurrence per confinement in 18th century and 19th century Europe, principally in Germany and France, have been summarised by Chesley.1 Davies15 has listed the 741 papers on the geographical distribution of occurrence of pre-eclampsia published up
References (48)
- et al.
Maternal placental vasculopathy and infection: two distinct subgroups among patients with preterm labor and preterm ruptured membranes
Am J Obstet Gynecol
(1993) - et al.
The remote prognosis of eclamptic women: sixth periodic report
Am J Obstet Gynecol
(1976) The oxidation hypothesis of atherosclerosis
Lancet
(1994)- et al.
Is oxidative stress the link in the two-stage model of pre-eclampsia?
Lancet
(1999) - et al.
Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: a randomized trial
Lancet
(1999) - et al.
Revisiting the epidemiological standard of preeclampsia: primigravidity or primipaternity?
Eur J Obstet Gynecol Reprod Biol
(1999) - et al.
Absence of close linkage between maternal genes for susceptibility to pre-eclampsia/eclampsia and the HLA DRB
Lancet
(1990) Severe preeclampsia associated with coinheritance of factor V Leiden mutation and protein S deficiency
Obstet Gynecol
(1998)- et al.
Evidence for a familial pregnancy-induced hypertension locus in the eNOS-c region
Am J Hum Genet
(1997) - et al.
Failure to detect linkage of preeclampsia to the region of the NOS3 locus on chromosome 7q
Am J Hum Genet
(1999)
A genome scan in Australian and New Zealand families confirms the presence of a maternal susceptibility locus for pre-eclampsia on chromosome 2
Am J Hum Genet
Hypertensive disorders or pregnancy
Endothelial dysfunction in preclampsia
Semin Reprod Endocrinol
The relation between hydatid moles, relative ischemia of the gravid uterus, and the placental origin of eclampsia
Am J Obstet Gynecol
The role of the spiral arteries in the pathogenesis of preeclampsia
Change in paternity: a risk factor for preeclampsia in multiparas
Epidemiology
Barrier contraceptive methods and preeclampsia
J Amer Med Assoc
Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational age infants
Br J Obstet Gynaecol
Hypertension in pregnancy: clinical-pathological correlations and remote prognosis
Medicine
Gynaecology from ancient Egypt: the papyrus Kahun–a translation of the old treatise of gynaecology that has survived from the ancient world
Med J Aust
Geographical epidemiology of the toxemias of pregnancy
Genomic imprinting, development and disease–is preeclampsia caused by a maternally imprinted gene?
Reprod Fertil Dev
The familial factor in toxemia of pregnancy
Obstet Gynecol
Genetic control of severe pre-eclampsia
Medical Genet
Cited by (1091)
The features of serous retinal detachment in preeclampsia viewed on spectral-domain optical coherence tomography
2024, Pregnancy HypertensionThe role of genetics in maternal susceptibility to preeclampsia in women of African ancestry
2023, Journal of Reproductive ImmunologySiglecs family used by pathogens for immune escape may engaged in immune tolerance in pregnancy
2023, Journal of Reproductive Immunology