Surface Expression of Neutrophil Adhesion Molecules in Pregnant Women at Risk for Hypertensive Complications

Objective: To determine if neutrophil activation is a pathogenetic factor in hypertensive disorders in pregnancy, the neutrophil expression of adhesion molecules was prospectively investigated in pregnant women at risk, prior to the development of hypertensive complications. Methods: Two neutrophil activation parameters, β₂-integrin (CDk11b) and L-selectin (CD62L), were assessed at admission between 14 and 24 weeks of gestation in 82 pregnant women at risk of preeclampsia and other hypertensive complications. Results were compared to those in 20 healthy normotensive women. Results: Of the 82 women at risk, 23 (28%) developed hypertensive complications: 9 (11%) preeclampsia and 14 (17%) others, such as intrauterine growth restriction (n = 6), fetal or neonatal loss (n = 8), and preterm delivery (≤ 30 weeks of gestation) (n = 8). All pregnancy outcome measures were significantly worse in the patients with complications than in those at risk but without complications or the healthy controls. Expression of β₂-integrin was significantly higher in early stages of pregnancy in the women who eventually developed complications than the women who did not, P = .019, or the healthy controls, P = .049. Conclusions: Surface expression of β ₂-integrin is increased in pregnant women at risk for hypertensive complications before the clinical manifestations of the disorder.