Altered circulating levels of adhesion molecules at 18 weeks’ gestation among women with eventual preeclampsia: Indicators of disturbed placentation in absence of evidence of endothelial dysfunction?

Objective: The purpose of this study was to investigate whether indications of activation of the maternal endothelium were present at 18 weeks’ gestation in women in whom preeclampsia eventually developed. Study Design: A total of 2190 blood samples were obtained at 18 weeks’ gestation. Circulating levels of von Willebrand factor and soluble vascular adhesion molecule 1, soluble intercellular adhesion molecule 1, and E-selectin were assayed in 71 women with eventual preeclampsia and 71 control subjects. Results: E-selectin and von Willebrand factor levels were similar between the 2 groups. Soluble vascular adhesion molecule 1 concentration was significantly lower in the women with eventual preeclampsia (median, 649.0 ng/mL vs 762.4 ng/mL; P < .001), whereas soluble intercellular adhesion molecule 1 concentration was significantly higher (median, 239.8 ng/mL vs 178.3 ng/mL; P < .001). Conclusion: We found no indications of endothelial activation at 18 weeks’ gestation in women in whom preeclampsia later developed. However, decreased serum concentration of soluble vascular adhesion molecule 1 and increased serum concentration of soluble intercellular adhesion molecule 1 may reflect the disturbed placentation known to be associated with the development of preeclampsia. (Am J Obstet Gynecol 2000;182:321-5.)