Molecular biology related to pre-eclampsia

Pre-eclampsia affects 3% of pregnancies and is a major cause of maternal and fetal morbidity and mortality. It is commoner in primigravidae and is characterised by abnormal placentation and endothelial dysfunction. Pre-eclampsia has a complex aetiology that is influenced by maternal and fetal genes in addition to environmental factors. Most genetic studies to date have focussed on maternal genes. There have been a large number of genetic linkage and association studies. While not all studies have consistent results for specific candidate genes/loci there are several genes in which the data are interesting in several studies, e.g. genes encoding the hereditary thrombophilias, elements of the renin-angiotensin system and HLA-G. Genome-wide scans have also identified a small number of chromosomal loci of interest, e.g. on chromosomes 2p13 and 10q22. However, most studies do not have sufficient power to definitively confirm or refute specific genes or loci of interest and few investigate the role of the fetal genotype. It is to be hoped that the larger, well-phenotyped DNA resources with maternal and fetal samples will overcome some of these problems.