Preeclampsia is a leading cause of maternal and offspring mortality and morbidity, and predicts increased future cardiovascular disease risk. Placental dysfunction and immune system dysregulation are likely key pathophysiological factors. Soluble human leukocyte antigen G (sHLA-G) may dampen the specific immune response towards placental trophoblasts. Previous studies have shown low sHLA-G levels in preeclampsia, but postpartum, levels are unknown. Furthermore, the relationship between sHLA-G and sFlt-1 and PlGF, placental function markers, is unknown. We hypothesized that low maternal sHLA-G during pregnancy would be associated with placental dysfunction, including preeclampsia, gestational hypertension, and dysregulated sFlt-1 and PlGF, and that sHLA-G would remain decreased following preeclampsia.

We included 316 pregnant women: 58 with early-onset preeclampsia (<34 weeks’ gestation), 81 with late-onset preeclampsia (≥34 weeks’ gestation), 25 with gestational hypertension, and 152 normotensive controls. Postpartum (1 or 3 years), we included 321 women: 29 with early-onset preeclampsia, 98 with late-onset preeclampsia, 57 with gestational hypertension, and 137 who were normotensive during their index pregnancies.

In pregnancy, plasma sHLA-G was significantly lower both in the early- and late-onset preeclampsia groups compared to controls. In women with preeclampsia or gestational hypertension, sHLA-G was inversely correlated with serum sFlt-1. Postpartum, plasma sHLA-G levels were significantly higher in women who had had early-onset preeclampsia compared to controls.

Our results support that sHLA-G may be important for placental function. Unexpectedly, sHLA-G was elevated up to 3 years after early-onset preeclampsia, suggesting an excessively activated immune system following this severe preeclampsia form, potentially contributing to future cardiovascular disease risk.

先兆子痫是导致母体和后代死亡和发病的主要原因，并预示着未来心血管疾病风险会增加。胎盘功能障碍和免疫系统失调可能是关键的病理生理因素。可溶性人类白细胞抗原 G (sHLA-G) 可能会抑制对胎盘滋养细胞的特异性免疫反应。先前的研究表明先兆子痫的 sHLA-G 水平较低，但产后的水平尚不清楚。此外，sHLA-G 与 sFlt-1 和 PlGF（胎盘功能标志物）之间的关系尚不清楚。我们假设怀孕期间母体 sHLA-G 低与胎盘功能障碍有关，包括先兆子痫、妊娠高血压和失调的 sFlt-1 和 PlGF，并且 sHLA-G 会在先兆子痫后保持下降。

我们纳入了 316 名孕妇：58 名患有早发性先兆子痫（<34 周妊娠），81 名患有迟发性先兆子痫（≥34 周妊娠），25 名患有妊娠高血压，以及 152 名血压正常的对照者。产后（1 年或 3 年），我们纳入了 321 名女性：29 名患有早发性先兆子痫，98 名患有迟发性先兆子痫，57 名患有妊娠高血压，137 名在首次妊娠期间血压正常。

在怀孕期间，与对照组相比，早发性和晚发性先兆子痫组的血浆 sHLA-G 均显着降低。在患有先兆子痫或妊娠高血压的女性中，sHLA-G 与血清 sFlt-1 呈负相关。产后，与对照组相比，患有早发性先兆子痫的女性的血浆 sHLA-G 水平显着更高。

我们的结果支持 sHLA-G 可能对胎盘功能很重要。出乎意料的是，sHLA-G 在早发性先兆子痫后长达 3 年升高，表明在这种严重的先兆子痫形式后免疫系统过度激活，可能导致未来的心血管疾病风险。