Adedeji Okikiade, Chidinma Kanu, Oluwadamilare Iyapo, Ololade Omitogun,
Volume 19, Issue 1 (4-2025)
Abstract
In accordance with The American College of Obstetricians and Gynecologists (ACOG) guidelines, hypertensive disorders during pregnancy remain a prominent contributor to maternal and perinatal mortality on a global scale. Toxemia of pregnancy is estimated to complicate 2–8% of pregnancies worldwide. It is predominantly in Latin America and the Caribbean, where it accounts for 26% of maternal deaths. In Africa and Asia, hypertensive disorders contribute to 9% of maternal deaths. Despite lower maternal mortality rates in high-income countries, 16% of maternal deaths can be attributed to hypertensive disorders.
The pathogenesis of the disease remains incompletely understood, but it is believed to be because of an imbalance between pro- and antiangiogenic factors. The imbalances are related to numerous triggers, namely, extreme ages, typically below 14 or over the age of 35, personal and family history of chronic Hypertension, preeclampsia, or diabetes. Additional risk factors include being overweight, primigravida, multiparity, and race (high among Black or Hispanic ethnicity). Systolic blood pressure at randomization, pre-pregnancy weight, smoking history, and the number of previous abortions or miscarriages were found to be associated with pre-eclampsia. The review aims to discuss the pathogenesis of Toxemia of pregnancy concerning the roles of cytokines and chemokines.
