Cause Of Preeclampsia Research Articles

Histopathology of Placentae in Pre-Eclampsia: A Review

Preeclampsia (PE) is a pregnancy related complex multisystemic disorder with a triad of symptoms including increased blood pressure, oedema, and proteinuria phenotypically observed after 20 weeks of gestation. The disorder worsens amongst the early onset patients PE (< 34 weeks). The placenta shares more responsibility for the cause of PE. The placenta is an essential organ for pregnancy and assists in the development of the fetus. It shares the same stress and strain to which the fetus is exposed. Any disease which affects the mother has a great impact on the placenta and also placenta acts as a future evidence of mother and fetus health. Therefore careful observation of histopathological changes can provide clinically useful information to pave the way for pathophysiology of PE. So the histopathological parameters like distal villous hypoplasia, accelerated villous maturity, increase in syncytial knots, immature villi, chorangiosis, fibrin deposition, infarction, and calcification are evident in histopathological observations of PE placentae. Keywords: Histopathology of placenta, Pre-eclampsia, Distal Villous Hypoplasia, Chorionic Villi, Villous maturity.

Body Mass Index (BMI) dengan Preeklampsia pada Ibu Hamil Trimester III

Preeclampsia if not treated properly, can lead to the death of the mother and baby. The cause of preeclampsia is unknown, women with a high BMI (Body Mass Index) or obesity before pregnancy are at greater risk for developing preeclampsia. This study is an observational analytic study with a case control approach with a retrospective approach. The purpose of this study was to determine the relationship between BMI and preeclampsia. The sample of this study was divided into case groups, namely third trimester pregnant women with preeclampsia and control group samples; namely third trimester pregnant women who did not experience preeclampsia. The number of samples in each group was 14 respondents. Data analysis using Chi Square statistical test. The results showed that most (19 respondents) pregnant women with TM III (67.9%) with abnormal BMI experienced preeclampsia as many as 13 respondents (46.4%). Meanwhile, of the 9 respondents of TM III pregnant women with normal BMI, most of them did not experience preeclampsia, namely 8 respondents (28.6%). Chi Square test results obtained p - value = 0.005 (< 0.05) which indicates there is a relationship between BMI and preeclampsia. More pregnancy monitoring in pregnant women with obesity and overweight categories is needed to avoid the occurrence of preeclampsia.

The association between chronic deciduitis and preeclampsia

Chronic deciduitis (CD) is slight inflammation of the decidua found during pregnancy. The cause of preeclampsia is thought to be placental hypoplasia, and various theories have been proposed to explain the detailed mechanism; however, its association with decidual inflammation is unclear. A retrospective case control study was conducted in a single university. Subjects were cases who delivered by cesarean section between January 1, 2013 and June 30, 2020 and whose placentas were pathological assessed. CD was diagnosed by CD138 immunostaining of placental decidua tissue, and the perinatal prognosis and incidences of hypertensive disorder of pregnancy and preeclmpsia were examined according to the presence or absence of CD. A logistic regression analysis was performed to evaluate the association between preeclampsia and 11 explanatory variables (10 patient or perinatal background factors and CD). The study population included 76 patients (non-CD, n = 54; CD, n = 22). The rate of preeclampsia was significantly higher in the CD group (P = 0.0006). Patients with CD gave birth at a significantly earlier gestational age (P=0.040) with a lower birth weight (P = 0.001), and a higher rate of LFD (P = 0.005). The Apgar scores at 1 and 5 min and umbilical artery pH were lower (P = 0.0003, 0.021 and 0.002, respectively) in the CD group. The logistic regression analysis revealed that CD was positively associated with preeclampsia. A retrospective examination of the placenta found that patients with CD had a significantly higher incidence of preeclampsia and CD is considered to be a factor that is associated with poor perinatal outcomes.

CircPAPPA Regulates the Proliferation, Migration, Invasion, Apoptosis, and Cell Cycle of Trophoblast Cells Through the miR-3127-5p/HOXA7 Axis.

Abnormal function of trophoblast cells is one of the important causes of preeclampsia (PE). Circular RNA (circRNA) is thought to be involved in the regulation of various diseases progression, including PE. However, the role of circRNA pregnancy-associated plasma protein A (circPAPPA) in PE is less studied. The expression levels of circPAPPA, miR-3127-5p, and homeobox A7 (HOXA7) were determined by quantitative real-time PCR. Cell proliferation was evaluated using MTT assay and colony formation assay. Besides, flow cytometry was used to detect cell apoptosis and cell cycle distribution. In addition, the interaction between miR-3127-5p and circPAPPA or HOXA7 was confirmed by dual-luciferase reporter assay and RNA immunoprecipitation assay. CircPAPPA was lowly expressed in the placental tissues of PE patients. Knockdown of circPAPPA inhibited proliferation, migration, and invasion, while induced apoptosis and cell cycle arrest in trophoblast cells. MiR-3127-5p could be targeted by circPAPPA, and its inhibitor reversed the effect of circPAPPA silencing on the biological function of trophoblast cells. Moreover, HOXA7 was a target of miR-3127-5p. HOXA7 overexpression reversed the effect of miR-3127-5p on the biological function of trophoblast cells. Our research indicated that circPAPPA positively regulated the biological function of trophoblast cells to mediate the progression of PE by miR-3127-5p/HOXA7 axis, which suggested that circPAPPA might be a potential biomarker for PE.

The effect of hypnosis on perceived stress in women with preeclampsia.

BACKGROUND:Perceived stress is one of the causes of preeclampsia; one of the ways to manage mental stress is hypnosis. The aim of this study was to determine the effect of hypnosis on perceived stress in women with preeclampsia.MATERIALS AND METHODS:This randomized clinical trial was performed on 80 (40 people in each group) pregnant women 28–32 weeks with preeclampsia and hospitalized in two public hospitals in Mashhad in 2020. The Cohen Perceived Stress Questionnaire was first completed in two groups. Then, in the intervention group, three half-hour sessions of hypnosis were performed with an interval of 3 days (hypnosis consists of three sessions: each session is held for three consecutive nights). After each session, the intervention package, which included recording the dialogs of each session for posthypnotic suggestion, was delivered to the mothers on a CD to listen to every night before bed. The control group received routine care. Then, 2 weeks after the intervention, the Perceived Stress Questionnaire was completed by both groups. The results were analyzed by independent t-test, paired t-test, Mann–Whitney, Chi-square, Friedman and covariance tests, and by SPSS 16.RESULTS:At the beginning of the study, there was no statistically significant difference between demographic characteristics and the perceived stress score before the intervention between the two groups (P > 0.05). However, after the intervention, the mean perceived stress score was a statistically significant difference between the intervention and control groups (P = 0.005). Perceived stress after the intervention was significantly reduced in the intervention group, which was significant between the two groups.CONCLUSION:Perceived stress in mothers with preeclampsia is reduced by hypnosis.

The Correlation of Maternal Age and the Incidence of Preeclampsia at Aura Syifa Hospital

Preeclampsia is a condition when hypertension and proteinuria occurs after 20 weeks of pregnancy. The exact cause of preeclampsia is currently unknown, but many factors influence the occurrence of preeclampsia, especially the age factor. This study was aimed to determine the correlation between maternal age and the incidence of preeclampsia. This study was analytical survey designed with retrospective study method. From Aura Syifa hospital, 142 medical records in of pregnant women in 2017 were taken 105 samples by using simple random sampling technique. The result of this study indicated that delivered mothers who were in reproductive age (20-35 years old), 25.8% of them had preeclampsia and 31,1% had severe preeclampsia. The data analyzed by suing chi-square correlation and the result was ρ (0.00) < α (0.05) which meant that there was a correlation between maternal age and the incidence of preeclampsia. It would be better for couples planning pregnancy in healthy reproductive age for minimize the risk of preeclampsia.

Estrogen-Induced Uterine Vasodilation in Pregnancy and Preeclampsia.

Normal pregnancy is associated with dramatically increased estrogen biosynthesis whose role is believed to raise uterine blood flow to facilitate the bi-directional maternal-fetal exchanges of gases (O2 and CO2), to deliver nutrients, and exhaust wastes to support fetal development and survival. Constrained uterine blood flow in pregnancy is a leading cause of preeclampsia with fetal growth restriction, rendering investigations of uterine hemodynamics to hold a high promise to inform pathways as targets for therapeutic interventions for preeclampsia. The mechanisms of estrogen-induced uterine vasodilation in pregnancy have long been attributed to enhanced endothelium production of nitric oxide, but clinical trials targeting this pathway that dominates uterine hemodynamics have achieved no to little success. Emerging evidence has recently shown a novel proangiogenic vasodilatory role of hydrogen sulfide in regulating uterine hemodynamics in pregnancy and preeclampsia, provoking a new field of perinatal research in searching for alternative pathways for pregnancy disorders especially preeclampsia and intrauterine growth restriction. This minireview is intended to summarize the nitric oxide pathway and to discuss the emerging hydrogen sulfide pathway in modulating estrogen-induced uterine vasodilation in pregnancy and preeclampsia.

Cardiac dysfunction and remodeling regulated by anti-angiogenic environment in patients with preeclampsia: the ANGIOCOR prospective cohort study protocol

BackgroundCardiovascular diseases (CVD) are cause of increased morbidity and mortality in spite of advances for diagnosis and treatment. Changes during pregnancy affect importantly the maternal CV system. Pregnant women that develop preeclampsia (PE) have higher risk (up to 4 times) of clinical CVD in the short- and long-term. Predominance of an anti-angiogenic environment during pregnancy is known as main cause of PE, but its relationship with CV complications is still under research. We hypothesize that angiogenic factors are associated to maternal cardiac dysfunction/remodeling and that these may be detected by new cardiac biomarkers and maternal echocardiography.MethodsProspective cohort study of pregnant women with high-risk of PE in first trimester screening, established diagnosis of PE during gestation, and healthy pregnant women (total intended sample size n = 440). Placental biochemical and biophysical cardiovascular markers will be assessed in the first and third trimesters of pregnancy, along with maternal echocardiographic parameters. Fetal cardiac function at third trimester of pregnancy will be also evaluated and correlated with maternal variables. Maternal cardiac function assessment will be determined 12 months after delivery, and correlation with CV and PE risk variables obtained during pregnancy will be evaluated.DiscussionThe study will contribute to characterize the relationship between anti-angiogenic environment and maternal CV dysfunction/remodeling, during and after pregnancy, as well as its impact on future CVD risk in patients with PE. The ultimate goal is to improve CV health of women with high-risk or previous PE, and thus, reduce the burden of the disease.Trial registrationNCT04162236

The Impact of PTPRK and ROS1 Polymorphisms on the Preeclampsia Risk in Han Chinese Women.

Objective Preeclampsia (PE) is a severe complication in pregnancy and a leading cause of maternal and infant mortality. However, the exact underlying etiology of PE remains unknown. Emerging evidence indicates that the cause of PE is associated with genetic factors. Therefore, the aim of this study is to identify susceptibility genes to PE. Materials and Methods Human Exome BeadChip assays were conducted using 370 cases and 482 controls and 21 loci were discovered. A further independent set of 958 cases and 1007 controls were recruited for genotyping to determine whether the genes of interest ROS1 and PTPRK are associated with PE. Immunohistochemistry was used for localization. Both qPCR and Western blotting were utilized to investigate the levels of PTPRK in placentas of 20 PE and 20 normal pregnancies. Results The allele frequency of PTPRK rs3190930 differed significantly between PE and controls and was particularly significant in severe PE subgroup and early-onset PE subgroup. PTPRK is primarily localized in placental trophoblast cells. The mRNA and protein levels of PTPRK in PE were significantly higher than those in controls. Conclusion These results suggest that PTPRK appears to be a previously unrecognized susceptibility gene for PE in Han Chinese women, and its expression is also associated with PE, while ROS1 rs9489124 has no apparent correlation with PE risk.

Pathological AT1R-B2R Protein Aggregation and Preeclampsia.

Preeclampsia is one of the most frequent and severe complications of pregnancy. Symptoms of preeclampsia usually occur after 20 weeks of pregnancy and include hypertension and kidney dysfunction with proteinuria. Up to now, delivery of the infant has been the most effective and life-saving treatment to alleviate symptoms of preeclampsia because a causative treatment does not exist, which could prolong a pregnancy complicated with preeclampsia. Preeclampsia is a complex medical condition, which is attributed to a variety of different risk factors and causes. Risk factors account for insufficient placentation and impaired vasculogenesis and finally culminate in this life-threatening condition of pregnancy. Despite progress, many pathomechanisms and causes of preeclampsia are still incompletely understood. In recent years, it was found that excessive protein complex formation between G-protein-coupled receptors is a common sign of preeclampsia. Specifically, the aberrant heteromerization of two vasoactive G-protein-coupled receptors (GPCRs), the angiotensin II AT1 receptor and the bradykinin B2 receptor, is a causative factor of preeclampsia symptoms. Based on this knowledge, inhibition of abnormal GPCR protein complex formation is an experimental treatment approach of preeclampsia. This review summarizes the impact of pathological GPCR protein aggregation on symptoms of preeclampsia and delineates potential new therapeutic targets.

Anti-inflammatory and Antioxidant Effects of Pyrroloquinoline Quinone in L-NAME-Induced Preeclampsia-Like Rat Model.

Preeclampsia (PE) is a pregnancy complication commonly characterized by high blood pressure. Although it is generally believed that the placenta is the root cause of PE, the exact pathogenesis is unknown; consequently, there is no standard clinical treatment. Therefore, it is necessary to explore new therapeutic drugs. Several studies have reported that pyrroloquinoline quinone (PQQ) exhibits anti-inflammatory and antioxidative effects. The purpose of this study was to investigate the protective effect of PQQ diet supplementation on PE-like rat models. L-NAME induced PE-like model rats were intraperitonially administrated with PQQ. The results showed that PQQ significantly improved clinical manifestations and pregnancy outcomes of PE-like rats. The levels of related inflammatory and antioxidant markers were also significantly reversed. A mechanism study showed that PQQ may achieve the above therapeutic effects by inhibiting NF-κB and promoting Nrf2 antioxidant pathways. In conclusion, we showed the protective effect of PQQ on PE-like model rats, by improving anti-inflammation and antioxidation effect through the NF-κB-Nrf2 pathway.

The Effect of Aerobic Exercise on Blood Pressure and Type of Labor in Primigravidas with Hypertension

Preeclampsia is one of the main causes of maternal mortality in Indonesia and in the world. The exact cause of preeclampsia is not known at this time. Aerobic exercise as an effort to prevent preeclampsia. The purpose of this study was to determine the effect of aerobic exercise on maternal outcome in primigravidas with a history of hypertension.
 
 This research was a quasy experimental research with pre and post control group. Aerobic exercise was carried out for 15 weeks in the second trimester of pregnancy, then blood pressure measurements were taken in both groups. The data will be analyzed using the t-test, and a p value <0.05 will be considered statistically significant.
 
 Systolic and diastolic blood pressures were lower in the intervention group than in the control group but not statistically significant, all samples became superimposed preeclampsia and underwent delivery by caesarean section.

Association of maternal Serum Selenium Binding protein and its effect on fetal outcomes in Pregnancy Induced Hypertensive Disorders: A case-control study.

Background: Pregnancy-induced hypertensive (PIH) disorder represented the primary cause of maternal and fetal morbidity and mortality. The cause of pre-eclampsia is unknown, but ischemic blood supply to the placenta stimulates the inflammatory process which leads to endothelial dysfunction and oxidative stress. Antioxidants like Selenium altered concentration involve in its pathogenesis. This study was proposed to find out the significance of Selenium as a biomarker in the pathophysiology of PIH disorders and its association with fetal outcomes.
 Methodology: This case-control study was conducted on 240 pregnant women, 20-40 weeks of gestation, divided into four groups equally. Normotensive control, investigational group 1 PIH, 2 Pre-eclamptic, and 3 Eclamptic. A structured questionnaire was administered and arterial blood pressure was measured and the blood sample was done for serum Selenium assessment through ELISA. A urine sample was collected and the level of proteinuria was assessed. Fetal wellbeing and signs of growth restriction were observed using ultrasound reports.
 Results: The mean age of the studied participants was 27.6 ± 5.3 years with the gestational age of 32.11 ± 4.56 weeks. The mean Serum Selenium levels (ng/ml) were significantly lower in investigational groups 67.93 ± 10.54 in PIH, 44.6 ± 13.19 in PE, and 36.38 ± 10.3 in Ec than 78.5 ± 8.2 control (p<0.05). The mean systolic, diastolic blood pressure and proteinuria were significantly high in case groups (p<0.05). Furthermore, we observed a significant inverse correlation of serum selenium with gestational age, systolic, diastolic blood pressure, proteinuria, fetal weight, and femur length in all four groups, whereas mainly positive significant correlation was elucidated with serum glutathione, PIH (r= 0.797, p<0.001), PE (r = 0.617, p>0.00), Ec (r=0.559, p=0.019) than control (r = 0.817, p<0.001).
 Conclusion: It is concluded that serum selenium level is significantly reduced in Pregnancy-induced hypertensive disorders and it has markedly affected maternal and fetal outcomes.

Periodontal Conditions and Pathogens Associated with Pre-Eclampsia: A Scoping Review.

Background: Pre-eclampsia, the second most frequent direct source of maternal mortality, is a multisystem gestational disorder characterized by proteinuria and maternal hypertension after the 20th gestational week. Although the causes of pre-eclampsia are still discussed, research has suggested that the placenta has a central place in the pathogenesis of this disease. Moreover, current surveys indicated that periodontal disorders observed during the pregnancy and more particularly, periodontal pathogens could be link to the risk of pre-eclampsia. Objectives: This article aims to review recent studies focusing on periodontal conditions and pathogens associated with pre-eclampsia. Methods: The process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Results: Metabolic conditions, immunological changes, fluctuating progesterone and estrogen levels of the pregnant woman induce a dysbiosis of the oral microbiota and contribute to increase inflammation of periodontal tissues. Periodontal pathogens could diffuse through the bloodstream inducing a placenta inflammatory response as well as inflammatory molecules produced in response to periodontopathogens could migrate through the bloodstream leading to a placenta inflammatory response. Also, periodontopathogens can colonize the vaginal microbiota through the gastrointestinal tract or during oro-genital contacts. Conclusion: A cumulative bi-directional relationship between periodontal conditions, pathogens and the pre-eclampsia exists.

Placental Findings in Preterm and Term Preeclampsia: An Integrative Review of the Literature.

Preeclampsia (PE) is a pregnancy complication associated with increased maternal and perinatal morbidity and mortality. The disease presents with recent onset hypertension (after 20 weeks of gestation) and proteinuria, and can progress to multiple organ dysfunction, with worse outcomes among early onset preeclampsia (EOP) cases (< 34 weeks). The placenta is considered the root cause of PE; it represents the interface between the mother and the fetus, and acts as a macromembrane between the two circulations, due to its villous and vascular structures. Therefore, in pathological conditions, macroscopic and microscopic evaluation can provide clinically useful information that can confirm diagnosis and enlighten about outcomes and future therapeutic benefit. To perform an integrative review of the literature on pathological placental findings associated to preeclampsia (comparing EOP and late onset preeclampsia [LOP]) and its impacts on clinical manifestations. Cases of EOP presented worse maternal and perinatal outcomes, and pathophysiological and anatomopathological findings were different between EOP and LOP placentas, with less placental perfusion, greater placental pathological changes with less villous volume (villous hypoplasia), greater amount of trophoblastic debris, syncytial nodules, microcalcification, villous infarcts, decidual arteriolopathy in EOP placentas when compared with LOP placentas. Clinically, the use of low doses of aspirin has been shown to be effective in preventing PE, as well as magnesium sulfate in preventing seizures in cases of severe features. The anatomopathological characteristics between EOP and LOP are significantly different, with large morphological changes in cases of EOP, such as hypoxia, villous infarctions, and hypoplasia, among others, most likely as an attempt to ascertain adequate blood flow to the fetus. Therefore, a better understanding of the basic macroscopic examination and histological patterns of the injury is important to help justify outcomes and to determine cases more prone to recurrence and long-term consequences.

HUBUNGAN USIA DAN PARITAS TERHADAP KEJADIAN PRE EKLAMPSIA DI RSD BALUNG JEMBER

&#x0D; &#x0D; &#x0D; One of the contributors to maternal and infant mortality is the incidence of preeclampsia that occurs during pregnancy. The cause of preeclampsia is still unknown, but it is suspected that age and parity are one of the triggers for this occurrence. Women of childbearing age who are nulliparous with extreme age under the age of less than 20 years and women with the age of more than 35 years are most commonly found to have preeclampsia. The design in this study is analytic with a cross sectional approach. The population of all mothers giving birth in the delivery room of RSD Balung Jember was 3594 in 2019. The number of samples taken using non-random sampling by purposive sampling was finally obtained by 97 respondents. In this study, the independent variables were maternal age and parity, while the dependent variable was the incidence of preeclampsia. The instrument used is medical records. The data is processed by editing, coding, processing and cleaning processes. Data were analyzed using multiple logistic regression. The results of the chi-square test for the age variable obtained that the Pearson chi-square value was 0.019 and the p value = 0.000 &lt;0.05 from these results Ho was rejected, and the parity variable the Pearson chi- square value was 0.019 and the p value = 0.000 &lt;0.05 from these results Ho is rejected. In conclusion, there is a relationship between age and preeclampsia, and there is a relationship between parity and preeclampsia.&#x0D; &#x0D; &#x0D;

SARS-CoV-2, Endothelial Dysfunction, and the Renin-Angiotensin System (RAS): A Potentially Dangerous Triad for the Development of Pre-Eclampsia

SARS-CoV-2 represents the greatest epidemiological, clinical, and social challenge the human being has had to face in this century. SARS-CoV-2 is not merely a respiratory virus, as its target cells range from upper airway respiratory cells to pulmonary cells but also and above all to the cardiovascular cells, such as pericytes and endothelial cells. Indeed, the pathology related to SARS-CoV-2, COVID-19, may be defined as a thromboinflammatory syndrome in its most severe form, characterized by sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulopathy (DIC), which is prevalent in individuals already presenting a chronic level of inflammation (e.g., obese individuals, elderly) and hypertension. Pregnancy is not only an inflammatory-prone condition but is characterized by a consistent rearrangement of the blood circulation and coagulation profile. Cardiac output increases while arterial systolic and diastolic pressure decrease, regardless of the activation of the RAS system. ACE2, the SARS-CoV-2 entry receptor into the host cells, which transforms Ang II in Ang 1–7, is highly expressed in endothelial, smooth muscle cells and pericytes of placental villi, regulating blood pressure and fetal development. Pre-eclampsia is a pregnancy disorder characterized by hypertension and low levels of ACE2, endothelial dysfunction, and a high production of pro-inflammatory cytokines, resembling COVID-19 manifestations. Whereas pre-eclampsia and COVID-19 have overlapping clinical features, a role for SARS-CoV-2 as a leading cause of pre-eclampsia in COVID-19 positive pregnant women has not been clarified yet. In this mini-review, we will explore the possibility of the existence of such a link, focusing on the role of endothelial dysfunction and RAS in both pre-eclampsia and SARS-CoV-2-induced COVID-19 pathogenesis.

A Longitudinal Pilot Study on Cognition and Cerebral Hemodynamics in a Mouse Model of Preeclampsia Superimposed on Hypertension: Looking at Mothers and Their Offspring.

Preeclampsia is a common hypertensive disorder in pregnant women and whose causes and consequences have focused primarily on cardiovascular outcomes on the mother and offspring, often without taking into consideration the possible effects on the brain. One possible cause of preeclampsia has been attributed to alterations in the renin-angiotensin system, which has also been linked to cognitive decline. In this pilot study, we use a transgenic mouse model that chronically overexpresses human angiotensinogen and renin (R+A+ mice) that displayed characteristics of preeclampsia such as proteinuria during gestation. Offspring of these mothers as well as from control mothers were also examined. We were primarily interested in detecting whether cognitive deficits were present in the mothers and offspring in the long term and used a spatial learning and memory task as well as an object recognition task at three timepoints: 3, 8, and 12 months post-partum or post-natal, while measuring blood pressure and performing urine analysis after each timepoint. While we did not find significant deficits in preeclamptic mothers at the later timepoints, we did observe negative consequences in the pups of R+A+ mice that coincided with hemodynamic alterations whereby pups had higher whisker-evoked oxygenated hemoglobin levels and increased cerebral blood flow responses compared to control pups. Our study provides validation of this preeclampsia mouse model for future studies to decipher the underlying mechanisms of long-term cognitive deficits found in offspring.

Decreased circUBAP2 Expression Is Associated with Preeclampsia by Limiting Trophoblast Cell Proliferation and Migration

Preeclampsia (PE) is a common obstetric disease and a major cause of maternal, newborn, and fetal death. This condition is a multisystem disorder characterized by hypertension, proteinuria, and involvement of the kidney, liver, and nervous system. It is generally believed that the placenta is the main cause of PE. circRNAs are a special class of noncoding RNAs that can form covalently closed continuous ring structures with tissue-specific conservation, and they have been reported to play a wide range of regulatory functions in various diseases, including PE. In this study, we reported a novel circUBAP2 (hsa_circ_0003496) and found that it was downregulated in placental tissues from patients with PE compared to healthy controls. After knocking down circUBAP2 in trophoblast cells, we found that cell proliferation and migration were significantly suppressed. In addition, preliminary mechanistic studies showed that circUBAP2 can sponge miR-1244, and FOXM1 was identified as a target gene for miR-1244. Cotransfection of si-circUBAP2 and a miR-1244 inhibitor partially reversed the suppressive effect induced by circUBAP2 depletion on proliferation and migration. In conclusion, the circUBAP2/miR-1244/FOXM1 axis might be a promising molecular marker for the diagnosis and treatment of PE.

Prediction of pre-eclampsia.

Pre-eclampsia is a leading cause of neonatal and maternal mortality and morbidity that complicates approximately 2-8% of all pregnancies worldwide. The precise cause of pre-eclampsia is not completely understood, with several environmental, genetic, and maternal factors involved in its pathogenesis and pathophysiology. An accurate predictor of pre-eclampsia will facilitate early recognition, close surveillance according to the individual risk and early intervention, and reduce the negative consequences of the disorder. Current evidence shows that no single test predicts pre-eclampsia with sufficient accuracy to be clinically useful. A combination of markers into multiparametric models may provide a more useful and feasible predictive tool for pre-eclampsia screening in the routine care setting than a test of either component alone. This review presents a summary of the current advances on prediction of pre-eclampsia, highlighting their performance and applicability. Key priorities when conducting research on predicting pre-eclampsia are also analyzed.