Increased systemic activation of neutrophils but not complement in preeclampsia

Objective: To investigate whether neutrophils and systemic complement are a ctivated in pregnancies complicated by preeclampsia more than in normal pre gnancies. Methods: We measured native complement components and activation products i n plasma by enzyme immunoassays in 19 women with uncomplicated pregnancies, 15 with preeclampsia before cesarean deliveries, and 16 nonpregnant women. Neutrophil activation was measured by specific enzyme immunoassays for mye loperoxidase and lactoferrin. Results: Myeloperoxidase was significantly higher in women with preeclampsi a (197 mug/L, 95% confidence interval [CI] 94, 646) than in women with unco mplicated pregnancies (124 mug/L, 95% CI 70, 289; P = .009), whereas lactof errin did not differ between groups. C4 was decreased in preeclamptic women (0.16 g/L, 95% Cl 0.07, 0.48) compared with women with uncomplicated pregn ancies (0.21, 95% CI 0.10, 0.30, P < .001). There were no differences for t he other native complement components. There was a significant decrease in C1rs-C1 inhibitor, 13 AU/mL (95% CI 9,34) versus 19 (95% CI 13, 38) (P <les s than or equal to> .001) in normal pregnant women compared with nonpregnan t women. There also was an increase in C3, C4, C9 (data not shown), C4bp, 1 32% (95% CI 94%, 161%) versus 91% (95% CI 57%, 128%); C3bc (7.4 AU/mL, 95% CI. 4.2, 10.7) versus 4.8 AU/mL (95% CI 3.2, 7.3) and C4bc (8.6 AU/mL, 95% CI 5.7, 14.0) versus 3.5 AU/mL (95% CI 2.2, 6.7) in normal pregnant women c ompared with nonpregnant women (P less than or equal to .001). Conclusion: Neutrophil activation in preeclampsia was shown by systemic inc reases in myeloperoxidase. Except for a decrease in C4, systemic complement activation could not be detected in preeclampsia. (C) 2001 by The American College of Obstetricians and Gynecologists.