Signs of immune dysregulation in second-trimester maternal blood RNA profiles in late-onset preeclampsia

Preeclampsia (PE) is a hypertensive disorder that affects 5% of pregnancies. It is characterized by new-onset hypertension and proteinuria after 20 weeks of gestation. We investigated maternal second-trimester peripheral blood gene expression profiles to identify potential biomarkers for predicting late-onset PE. We found significant associations between PE and several inflammatory and immunological pathways, including the JAK-STAT signaling, leukocyte transendothelial migration, systemic lupus erythematosus (SLE), and graft versus host disease (GVHD). Twelve candidate biomarkers were identified, with high predictive power (AUC 0.74-0.87) for late-onset PE. These biomarkers were also associated with various blood cell populations, particularly intermediate monocytes. Our study highlights the role of maternal immune dysregulation in PE and the potential of second-trimester blood RNA profiles in disease prediction.