ISSN 0300-9092 (Print)
ISSN 2412-5679 (Online)

Unresolved issues regarding etiopathogenesis of preeclampsia as a neurogenic neuroimmune phenomenon of the perinatal period

Sidorova I.S., Managadze I.D.

I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow, Russia

The issue of preeclampsia, a severe protein-dependent hypertensive complication of the second half of pregnancy which is the leading cause of maternal and perinatal morbidity and mortality worldwide, continues to show fluctuating trends. It remains a significant concern and raises a wide range of unresolved questions, including etiopathogenesis, the search for potential biomarkers, as well as prognostic, diagnostic and therapeutic approaches. This review suggests that preeclampsia should be regarded as a phenomenon of stress-induced maladaptation during the perinatal period, involving a conflict between the mother and the fetus, associated with impairments in neurocorticogenesis and the development of the structures and functions of higher nervous activity, as well as the integrity and permeability of the blood-brain barrier (BBB). This is reflected in changes in the levels of neuron-specific proteins (NSPs) in maternal blood serum, alongside the process of complement-mediated destructive gestational endotheliosis induced by maternal agonistic autoantibodies.
The review includes papers on this topic available in the PubMed, Google Scholar and eLibrary databases, published from 2016 to 2026.
Conclusion. The article opens up new areas of research into the etiopathogenetic mechanisms of preeclampsia as a neurogenic neuroimmune phenomenon, and explores the potential for identifying innovative, prognostically valuable diagnostic and therapeutic targets. The paper also discusses early predictors of neurological complications in children born to mothers with preeclampsia. The obtained findings may transform both approaches to the monitoring and management of pregnancy and our understanding of the etiopathogenetic nature of preeclampsia as a whole.

Authors’ contributions. Sidorova I.S. – developing the concept and design of the study, editing the text; Sidorova I.S., Managadze I.D. – collecting and analyzing the literature data, writing the text.
Conflicts of interest. The authors declare that there are no conflicts of interest.
Funding. The study was conducted without sponsorship.
Generative Artificial Intelligence. The authors did not use any AI tools to generate the text of the article.
For citation: Sidorova I.S., Managadze I.D. Unresolved issues regarding etiopathogenesis of 
preeclampsia as a neurogenic neuroimmune phenomenon of the perinatal period.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (7): 13-23 (in Russian)
https://dx.doi.org/10.18565/aig.2025.346

Keywords

preeclampsia
neurocorticogenesis
neuron-specific proteins
BBB
fetal neurodevelopment

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Received 24.11.2025

Accepted 02.06.2026

About the Authors

Iraida S. Sidorova, Dr. Med. Sci., Professor, Academician of the RAS, Merited Scholar of the Russian Federation, Merited Doctor of the Russian Federation, Professor at the Department of Obstetrics and Gynecology No. 1, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
(Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8, bld. 2, +7(499)248-67-29, sidorovais@yandex.ru, https://orcid.org/0000-0003-2209-8662
Ioanna D. Managadze, Resident and PhD student at the Department of Obstetrics and Gynecology No. 1, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8, bld. 2, +7(499)248-67-29, ktb1966@mail.ru,
https://orcid.org/0000-0001-8745-9372
Corresponding author: Ioanna D. Managadze, ktb1966@mail.ru

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