Researchers at University College London and University College London Hospitals have identified a set of biological changes that may help explain severe preeclampsia, a pregnancy complication that affects 2% to 4% of pregnancies globally and can threaten the health of both mother and baby. The findings, published in Science Advances, point to stressed placental cells, poorly functioning blood vessels and an overactive immune response as key contributors to the condition.
Cell-level analysis reveals a wider disease process
The study examined tissue and individual cells from 20 pregnant women, including 10 with severe preeclampsia and 10 without the condition. Using genomic testing, the team compared placental cells with cells from nearby maternal and fetal tissues to build a more detailed picture of how the disease develops across gestation.
The researchers found that in severe cases, placental cells showed signs of stress, low oxygen and disrupted energy use. They also identified problems in cells responsible for reshaping the mother’s blood vessels, which may reduce blood flow to the baby. Alongside these changes, the team observed signs of immune overactivity not only in the placenta, but also in surrounding tissues and in the mother’s blood.
Why the findings matter for treatment development
Preeclampsia can lead to swelling, headaches, blurred vision and pain under the ribs, and in severe cases it may slow fetal growth or become life-threatening if untreated. The researchers say their work could help identify biological pathways that are more directly targetable with future therapies, especially in early-onset and more serious cases.
Senior author Professor Sara Hillman said the study looked at individual cells from both mother and baby to compare healthy pregnancies with preeclampsia, helping the team confirm suspected changes and uncover new ones. Co-lead author Dr Yara Sanchez Corrales said the findings point to specific biological processes that could be targeted with treatments to improve outcomes and reduce the risks associated with severe preeclampsia.
Next steps in pregnancy research
The research was funded by the Medical Research Council and the NIHR GOSH Biomedical Research Centre, with support from the UCLH BRC. The team noted that the work was limited by the small number of donors, particularly when analysing rare cell types, and said future studies with more participants could provide an even clearer picture of the disease.
For now, the study adds weight to the idea that preeclampsia is not driven by a single tissue alone. By showing how placental stress, vascular dysfunction and immune activation interact across the pregnancy environment, the research offers a stronger foundation for developing treatments that could one day help reduce premature births and save lives. For more details, see the original research published by UCL and referenced in News Medical and the related UCL-backed study summary on The BMJ.
