Midregional pro-adrenomedullin plasma concentrations are blunted in severe preeclampsia

• MR-proADM is a predictive and prognostic biomarker of heart failure and pneumonia.
• Animal models have defined a critical role for adrenomedullin in placentation.
• We conclude that MR-proADM is a novel plasma biomarker for severe preeclampsia.
• MR-proADM is similarly effective as endoglin at classifying patients from controls.

Levels of the peptide hormone adrenomedullin (AM) are elevated during normal pregnancy, but whether this differs during complications of pregnancy remains unresolved. AM can be quantified by measuring its pre-prohormone byproduct, midregional pro-adrenomedullin (MR-proADM). MR-proADM has shown prognostic value as a biomarker of heart failure, sepsis, and community-acquired pneumonia. Given the relevance of AM to pregnancy, we tested the hypothesis that MR-proADM provides a biomarker for preeclampsia. We find that MR-proADM plasma concentrations are blunted in severe preeclampsia and that MR-proADM is similarly effective as established biomarkers endoglin and placental growth factor at discriminating patients with severe preeclampsia from controls.