Maternal serum hormonal factors in the pathogenesis of preeclampsia

Abstract

The etiology of preeclampsia (PE) remains unknown. There are many different etiopathogenetic theories that have been proposed. One theory is based on immunologic factors that may be regulated by hormones. The primary objective of the present study was to review the main hormones that may be involved in the PE pathophysiology. The current literature has suggested the involvement of many different hormonal systems in the pathogenesis of PE such as cortisol, renin-angiotensin-aldosterone system, arginine vasopressin, epinephrine and norepinephrine, natriuretic atrial peptide, brain natriuretic peptide, and melatonin. These findings suggest the complexity of the pathophysiology of PE, which involves many different hormonal systems. In conclusion, PE is a systemic disease with all of the aforementioned hormones being involved in the mechanism of systemic arterial hypertension. This consequently plays an important role in the circadian characteristics of the maternal blood pressure in PE.

Target audience: Obstetricians and gynecologists, family physicians.

Learning objectives: After completing this CME activity, physicians should be better able to understand the pathogenesis and pathophysiologicprocess involved in this disease, improve the treatment of the disease, educate medical students and residents with a better comprehension of the pathophysiologic process of the disease, stimulate new researches to establish the regulations of these hormones all together in the pathophysiologic process of preeclampsia, and develop new methods for screening and prevention preeclampsia based on maternal serum evaluations of hormonal levels.