Markers of preeclampsia and the relationship to cardiovascular disease: review of the twenty-first century literature

Abstract

Objective. The objective of this article was to review the literature to identify the most promising markers of preeclampsia (PE) and the relationship to cardiovascular disease to gain a better understanding of the mechanism of PE to identify women at risk for cardiovascular disease to improve their outcomes.

Methods. Forty case–control studies were assessed for relationships between different serum markers to identify PE and to identify markers that may predict women who may be at greater risk for cardiovascular sequela in later life.

Results. Angiogenic, proteomic, and tumor necrosis markers were the most promising and important in the development of PE. The interplay among various growth factors, hormones, proteins, and other molecular compounds appears to be critical in the development of PE. Specific angiogenic (sVEGF, PLGF) and antiangiogenic (sFlt-1, sENG) markers and proteomic markers (fibrinogen and a-1-antichymotrypsin, SERPINA1, albumin, 1-antichymotryps) are the most promising markers of PE. Evidence of metabolic abnormalities associated with PE and common markers with cardiovascular disease include free leptin concentration which increases in normal pregnancy and is further increased in PE.

Conclusions. Markers are important to help understand disease, potentially identify women at risk to improve their outcomes, design therapies to ameliorate symptoms so that pregnancy can be prolonged and neonatal outcomes improved, and provide a better understanding the link between PE and increased risk for disease later in life.

Keywords:

• Markers
• preeclampsia
• cardiovascular disease
• eclampsia

Acknowledgements

We are grateful for the advice and review of this manuscript by Dr Wolfgang Tretter, MD, OB/GYN formerly of Columbia University Medical School, and Columbia University Medical Group, Harkness Pavillion.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.