The relationship of smoking, preeclampsia, and secretory component

OBJECTIVE: We sought to determine whether total secretory component in seru m is increased in women in whom preeclampsia subsequently develops. STUDY DESIGN: Serum samples were collected serially throughout pregnancy an d post partum from nulliparous women (N = 1496). Serum concentrations of to tal secretory component were measured by an enzyme-linked immunosorbent ass ay in all women in whom preeclampsia developed (n = 71) and a randomly sele cted group of normotensive women (n = 83). RESULTS: Secretory component increased with smoking (P = .0003) and with ge station (P = .0001), In the whole group secretory component was not differe nt in women with preeclampsia (P = .10), but there was a significant intera ction of smoking, gravidity, and preeclampsia (P = .04). Among the women wh o smoked, secretory component was lower in women in whom preeclampsia subse quently developed compared with those who remained normotensive (P = .02). This difference was significant from 15 to 19 weeks' gestation. CONCLUSION: Very high serum concentrations of secretory component in smoker s may protect against the development of preeclampsia and may indicate the involvement of mucosal tolerance.