Russian Military Medical Academy ReportsRussian Military Medical Academy ReportsИзвестия Российской Военно-медицинской академии2713-23152713-2323Eco-Vector64315210.17816/rmmar643152GQWUDZReviewsНаучные обзорыReview ArticleRisks and mechanisms of preeclampsiaРиски и механизмы развития преэклампсииhttps://orcid.org/0000-0002-6599-99068450-3464RudaevaElena V.РудаеваЕлена Владимировна
Russian Federation

MD, Cand. Sci. (Medicine), Associate Professor

кандидат медицинских наук, доцент

rudaevaeg1951@mail.ruhttps://orcid.org/0000-0002-3269-90185854-6890MozesVadim G.МозесВадим Гельевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

доктор медицинских наук, профессор

vadimmozes@mail.ruhttps://orcid.org/0000-0003-3729-616X8816-7409KashtalapVasily V.КашталапВасилий Васильевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

медицинских наук, профессор

v_kash@mail.ruhttps://orcid.org/0000-0002-6966-26817696-6446ElginaSvetlana I.ЕлгинаСветлана Ивановна
Russian Federation

MD, Dr. Sci. (Medicine), Professor

доктор медицинских наук, профессор

elginas.i@mail.ruKemerovo State Medical UniversityКемеровский государственный медицинский университетKemerovo State UniversityКемеровский государственный университетResearch Institute for Complex Issues of Cardiovascular DiseasesНаучно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний050820254421952051812202402032025Copyright ©; 2025, Eco-VectorCopyright ©; 2025, Эко-ВекторCopyright ©; 2025,2025Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0https://journals.eco-vector.com/RMMArep/article/view/643152

BACKGROUND: Preeclampsia is a specific pregnancy complication associated with a high cardiovascular risk in both mothers and neonates. Recent research has focused on understanding its underlying mechanisms, which involve differential methylation of cytosine-phosphate-guanine islands and alterations in microRNA expression, genetic and epigenetic factors, and various biomolecules involved in inflammation, oxidative stress, and angiogenesis, etc. Through all these mechanisms, preeclampsia-induced vascular abnormalities may be linked with the pathogenesis of potential cardiovascular diseases. This review explores the diverse mechanisms underlying preeclampsia and the associated cardiovascular changes in pregnant women. The review findings may inform potential strategies for early diagnosis and targeted treatment of preeclampsia.

AIM: to analyze published data on the risks and pathophysiological mechanisms of preeclampsia.

The review was conducted in 2024 using the eLibrary and PubMed databases. The following search queries were used: риски развития преэклампсии (risks of preeclampsia), механизмы развития преэклампсии (mechanisms of preeclampsia), осложнения при преэклампсии (complications of preeclampsia), and сердечно-сосудистые заболевания как осложнение преэклампсии (cardiovascular diseases as a complication of preeclampsia). Currently, there is no consensus regarding the true etiology of preeclampsia. It is often referred to as a disease of theories, which may reflect the fact that the primary biological mechanisms connecting clinical and epidemiological data with organ dysfunction, remain elusive. Despite the lack of definitive evidence, many experts favor the hypothesis that preeclampsia is a primary placental disease. Ongoing efforts are focused on developing effective strategies for screening, diagnosis, treatment, and improving maternal postpartum cardiovascular outcomes.

CONCLUSION: Preeclampsia is a pregnancy-specific complication with a multifactorial etiology, involving abnormal placentation, endothelial dysfunction, systemic inflammation, and oxidative stress. Despite advancements in understanding its underlying mechanisms, effective prevention and treatment options remain limited. The increased risk of cardiovascular diseases in women with preeclampsia may be associated with genetic predisposition, epigenetic modifications during pregnancy, and placental abnormalities.

Актуальность. Преэклампсия — это специфическое осложнение беременности, связанное с высоким риском возникновения сердечно-сосудистых заболеваний как у женщин, так и у их будущих детей. В настоящее время изучаются механизмы ее развития, связанные с дифференциальным метилированием цитозин-фосфат-гуанозиновых островов и изменением в экспрессии микроРНК, генетические и эпигенетические факторы, а также ряд биомолекул, участвующих в воспалении, окислительном стрессе, ангиогенезе и др. Все эти механизмы могут связывать нарушения сосудистого русла беременности при преэклампсии с патогенезом будущих сердечно-сосудистых заболеваний. В данном обзоре рассмотрены различные механизмы развития преэклампсии и изменения сердечно-сосудистой системы у беременных женщин с этим осложнением. Возможно, данные обзора представят потенциальные стратегии диагностики и лечения преэклампсии.

Цель — анализ имеющихся литературных данных о рисках и механизмах развития преэклампсии.

Обзор публикаций проведен в 2024 г. в базах eLibrary и PubMed. Использовались следующие поисковые запросы: «риски развития преэклампсии», «механизмы развития преэклампсии», «осложнения при преэклампсии», «сердечно-сосудистые заболевания как осложнение преэклампсии». Установлено, что все еще не существует единого мнения относительно истинной этиологии преэклампсии. Ее называют «болезнью теорий», вероятнее всего, это связано с тем, что основные биологические механизмы, связывающие клинические и эпидемиологические данные с дисфункцией органов при преэклампсии, пока недостаточно ясны. Несмотря на отсутствие последовательных доказательств, эксперты склоняются в пользу предположения, что преэклампсия является первичным плацентарным расстройством. В настоящее время все еще разрабатываются эффективные стратегии скрининга, диагностики, терапии и улучшения послеродового сердечно-сосудистого исхода у матери.

Заключение. Преэклампсия — это специфическое осложнение беременности с многофакторным происхождением, включающее аномальную плацентацию, эндотелиальную дисфункцию, системное воспаление и окислительный стресс. Несмотря на достижения в понимании ее патофизиологии, эффективные стратегии профилактики и лечения остаются ограниченными. Риски развития сердечно-сосудистых заболеваний при преэклампсии, вероятнее всего, связаны с существующим семейным генетическим фоном, эпигенетическими изменениями во время беременности, а также аномалиями развития плаценты.

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