Risks and Mechanisms of Preeclampsia

BACKGROUND: Preeclampsia is a specific pregnancy complication associated with a high cardiovascular risk in both mothers and neonates. Recent research has focused on understanding its underlying mechanisms, which involve differential methylation of cytosine-phosphate-guanine islands and alterations in microRNA expression, genetic and epigenetic factors, and various biomolecules involved in inflammation, oxidative stress, and angiogenesis, etc. Through all these mechanisms, preeclampsia-induced vascular abnormalities may be linked with the pathogenesis of potential cardiovascular diseases. This review explores the diverse mechanisms underlying preeclampsia and the associated cardiovascular changes in pregnant women. The review findings may inform potential strategies for early diagnosis and targeted treatment of preeclampsia. AIM: to analyze published data on the risks and pathophysiological mechanisms of preeclampsia. The review was conducted in 2024 using the eLibrary and PubMed databases. The following search queries were used: риски развития преэклампсии (risks of preeclampsia), механизмы развития преэклампсии (mechanisms of preeclampsia), осложнения при преэклампсии (complications of preeclampsia), and сердечно-сосудистые заболевания как осложнение преэклампсии (cardiovascular diseases as a complication of preeclampsia). Currently, there is no consensus regarding the true etiology of preeclampsia. It is often referred to as a disease of theories, which may reflect the fact that the primary biological mechanisms connecting clinical and epidemiological data with organ dysfunction, remain elusive. Despite the lack of definitive evidence, many experts favor the hypothesis that preeclampsia is a primary placental disease. Ongoing efforts are focused on developing effective strategies for screening, diagnosis, treatment, and improving maternal postpartum cardiovascular outcomes. CONCLUSION: Preeclampsia is a pregnancy-specific complication with a multifactorial etiology, involving abnormal placentation, endothelial dysfunction, systemic inflammation, and oxidative stress. Despite advancements in understanding its underlying mechanisms, effective prevention and treatment options remain limited. The increased risk of cardiovascular diseases in women with preeclampsia may be associated with genetic predisposition, epigenetic modifications during pregnancy, and placental abnormalities.