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Adolescent Preeclampsia: Pathological Drivers and Clinical Prevention

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Abstract

Preeclampsia is an important cause of maternal and perinatal morbidity, especially in first-time pregnant adolescent women. Although prevention of preeclampsia has been attempted for many decades, effective intervention can only be achieved upon the full elucidation of the risk factors and mechanisms of disease. As the pathogenesis of preeclampsia during adolescence may differ from that in older women, preventive interventions should be tailored accordingly. During adolescence, 4 putative drivers of preeclampsia can be identified. First, uterine immaturity in very young teenagers is likely a major cause of defective deep placentation and adverse reproductive outcome, underscoring the importance of educational programs and public health initiatives focused on teen pregnancy prevention. Second, the association between adolescent obesity and preeclampsia merits further studies on the benefits of weight loss and dietary interventions to improve pregnancy outcome. Third, there is a need for greater awareness of the link between cardiovascular risk factors in young women and early-onset preeclampsia associated with atherosclerosis of the uteroplacental arteries. Finally, infrequent menstruations may prolong uterine immaturity because of lack of “menstrual preconditioning.” This risk factor may be amenable to pharmacological/hormonal preconditioning prior to conception.

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Authors and Affiliations

  1. Faculty of Medicine, KU Leuven, Leuven, Belgium

    Ivo Brosens MD, PhD

  2. Division of Biomedical Sciences, Clinical Science Research Laboratories, Warwick Medical School, University of Warwick, Coventry, CV2 2DX, UK

    Joanne Muter PhD, Lauren Ewington MD & Jan J. Brosens MD, PhD

  3. Leuven Institute for Fertility and Embryology, Leuven, Belgium

    Patrick Puttemans MD

  4. Department of Biomedical, Experimental and Clinical Sciences (Mario Serio), University of Florence, Florence, Italy

    Felice Petraglia MD, PhD

  5. Department of Gynaecology, Obstetrics and Urology, “Sapienza” University, Rome, Italy

    Giuseppe Benagiano MD, PhD

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  1. Ivo Brosens MD, PhD
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  2. Joanne Muter PhD
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  3. Lauren Ewington MD
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  6. Jan J. Brosens MD, PhD
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Correspondence to Jan J. Brosens MD, PhD.

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Brosens, I., Muter, J., Ewington, L. et al. Adolescent Preeclampsia: Pathological Drivers and Clinical Prevention. Reprod. Sci. 26, 159–171 (2019). https://doi.org/10.1177/1933719118804412

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