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Adedeji Okikiade, Chidinma Kanu , Oluwadamilare Iyapo , Ololade Omitogun ,
Volume 19, Issue 1 (Jan-Feb 2025)
Abstract

Background: Hypertensive disorders, particularly preeclampsia (PE), complicate 2–8% of pregnancies and significantly contribute to maternal and perinatal mortality. PE disproportionately affects low-resource regions, accounting for 26% of maternal deaths in Latin America and 9% in Africa and Asia. Risk factors include extreme maternal age, chronic hypertension, obesity, diabetes, and racial disparities (Higher incidence in Black and Hispanic populations). The exact cause remains unclear, but angiogenic imbalance and immune dysregulation play key roles. This review focuses on the role of cytokines and chemokines in developing preeclampsia (PE).
Methods: A narrative review was conducted to examine studies on the immunological and vascular mechanisms of preeclampsia, with a focus on recent systematic reviews and high-impact research.
Results: The results highlighted a critical imbalance between pro-inflammatory (IL-6, TNF-α) and anti-inflammatory (IL-4, IL-10) cytokines in PE pathogenesis. Notably, reduced second-trimester IL-10 levels served as an early predictive biomarker. Endothelin-mediated vasoconstriction and Th1/Th2 immune imbalance further exacerbated endothelial dysfunction, a central feature of PE. While human and animal studies support these findings, precise mechanistic pathways remain elusive.
Conclusion: Cytokine and endothelin can serve as promising biomarkers and therapeutic targets for PE. Early IL-10 detection may improve risk prediction, but no causal links have been confirmed yet. Gaining a better understanding of these mediators could improve clinical strategies and help minimize complications. Future longitudinal research should focus on biomarkers and explore anti-inflammatory treatments for PE prevention.

 

Adedeji Okikiade , Chidinma Kanu , Oluwadamilare Iyapo , Ololade Omitogun,
Volume 19, Issue 3 (7-2025)
Abstract

Background: Pregnancy-induced hypertension (PIH) is a multi-system disorder affecting 6-8% of pregnancies in the U.S. and contributing significantly to maternal mortality, accounting for 16% in developed countries. It progresses from preeclampsia to eclampsia, leading to multi-organ damage through mechanisms such as oxidative stress, placental ischemia, and endothelial dysfunction. While the exact pathogenesis remains unclear, genetic, immunologic, and environmental factors are implicated. The American College of Obstetricians and Gynecology (ACOG) recommends initiating treatment when diastolic blood pressure exceeds 105-110 mmHg.
Methods: This narrative review examines existing literature on PIH, including epidemiological data, pathophysiological mechanisms, clinical management guidelines, and associated complications such as abnormal placentation, oxidative stress, and endothelial dysfunction.
Results: This study demonstrates that hypertensive disorders of pregnancy (HDP) significantly impact maternal and fetal health, particularly in developing countries with limited healthcare access. Early detection and continuous monitoring play a key role in reducing complications. Additionally, HDP is associated with increased long-term cardiovascular and metabolic risks, highlighting the importance of postpartum follow-up.
Conclusion: HDP poses a serious threat to maternal and fetal health, with potential long-term consequences. Effective management requires early diagnosis, close monitoring, and postpartum follow-up. Global implementation of risk assessment and targeted care strategies can help reduce the burden of this condition. Strengthening healthcare systems and increasing awareness among healthcare providers and patients are essential steps toward improving outcomes.


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