The etiology of preeclampsia
5
item.page.dc.date.issued
2022-02-01
item.page.dc.type
item.page.dc.identifier.issn
00029378
item.page.dc.identifier.eissn
10976868
item.page.dc.identifier.doi
item.page.dc.identifier.scopus
2-s2.0-85124562836
item.page.dc.identifier.pmid
35177222
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American Journal of Obstetrics and Gynecology
item.page.oaire.citation.volume
226
item.page.oaire.citation.issue
2
item.page.oaire.citation.startPage
S844
item.page.oaire.citation.endPage
S866
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SCOPUS
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American Journal of Obstetrics and Gynecology Vol.226 No.2 (2022) , S844-S866
punsarn.item.page.citation
Jung E. The etiology of preeclampsia. American Journal of Obstetrics and Gynecology Vol.226 No.2 (2022) , S844-S866. S866. doi:10.1016/j.ajog.2021.11.1356 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/86146
item.page.dc.title
The etiology of preeclampsia
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item.page.dc.description.abstract
Preeclampsia is one of the “great obstetrical syndromes” in which multiple and sometimes overlapping pathologic processes activate a common pathway consisting of endothelial cell activation, intravascular inflammation, and syncytiotrophoblast stress. This article reviews the potential etiologies of preeclampsia. The role of uteroplacental ischemia is well-established on the basis of a solid body of clinical and experimental evidence. A causal role for microorganisms has gained recognition through the realization that periodontal disease and maternal gut dysbiosis are linked to atherosclerosis, thus possibly to a subset of patients with preeclampsia. The recent reports indicating that SARS-CoV-2 infection might be causally linked to preeclampsia are reviewed along with the potential mechanisms involved. Particular etiologic factors, such as the breakdown of maternal-fetal immune tolerance (thought to account for the excess of preeclampsia in primipaternity and egg donation), may operate, in part, through uteroplacental ischemia, whereas other factors such as placental aging may operate largely through syncytiotrophoblast stress. This article also examines the association between gestational diabetes mellitus and maternal obesity with preeclampsia. The role of autoimmunity, fetal diseases, and endocrine disorders is discussed. A greater understanding of the etiologic factors of preeclampsia is essential to improve treatment and prevention.