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Maternal Serum Hormonal Factors in the Pathogenesis of Preeclampsia

Salustiano, Eugênia Maria Assuncão RN; De Pinho, Joao Correia MD; Provost, Karli MS; Ruano, Rodrigo MD, PhD§¶; Zugaib, Marcelo MD, PhD

Obstetrical & Gynecological Survey: February 2013 - Volume 68 - Issue 2 - p 141–150
doi: 10.1097/OGX.0b013e31827f2500
CME Review Article: Maternal Serum Hormonal Factors and Preeclampsia

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 pathophysiologic process 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.

*Student, ¶Professor, ∥Chairman, Department of Obstetrics and Gynecology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; †Resident, ‡Medical Student, §Professor, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX

All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.

Correspondence requests to: Rodrigo Ruano, MD, PhD, Texas Children’s Pavilion for Women, Department of Obstetrics and Gynecology, Baylor College of Medicine, 6651 Main St, Suite 1020, Houston, TX 77030. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.