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Published on: January 26, 2024
Cholelithiasis is an additional pre-pregnancy clinical risk factor for preeclampsia
Svitlana Arbuzova1,2, Margaryta Nikolenko3, David Wright4
1Eastern-Ukrainian Center for Medical Genetics and Prenatal Diagnosis, Mariupol & Kiev, Ukraine. s.arbuzova@exeter.ac.uk.
Insights
Gallstones (cholelithiasis) significantly increase preeclampsia risk. This finding may aid prenatal screening and understanding of preeclampsia causes.
Area of Science:
- Obstetrics and Gynecology
- Clinical Risk Factor Identification
- Pregnancy Complications
Background:
- Preeclampsia poses significant risks to maternal and fetal health.
- Identifying novel clinical risk factors is crucial for improving prediction and management.
- Existing risk factors for preeclampsia do not fully account for all cases.
Purpose of the Study:
- To investigate potential, previously unreported clinical risk factors for preeclampsia.
- To identify new indicators for preeclampsia risk assessment in pregnant individuals.
Main Methods:
- A nested case-control study design was employed.
- Data collected via questionnaires and telephone interviews from cases and controls.
- Preeclampsia diagnosis based on international criteria.
Main Results:
- A 17-fold higher prevalence of gallstones (cholelithiasis) was observed in preeclampsia cases compared to controls.
- A statistically significant association between cholelithiasis and preeclampsia was found (P < 0.0001).
- Family history of gallstones also showed a significant association with preeclampsia risk.
Conclusions:
- Cholelithiasis emerges as a novel and significant clinical risk factor for preeclampsia.
- Confirmation in further studies could support its use in routine prenatal screening.
- This finding may offer new insights into the underlying pathogenesis of preeclampsia.
Purpose:
To investigate additional potential clinical risk factors for preeclampsia.
Methods:
This is a nested case-control study of preeclampsia and unaffected pregnancies. Cases were either from a prenatal screening database or from a national network of clinicians, and controls were from the same prenatal source. Preeclampsia was defined by international criteria which were endorsed by the Ukraine Ministry of Health. Questionnaires were used to record a range of pregnancy related factors, personal history of health conditions and family history, followed by a telephone interview to collect more details.
Results:
There were 103 cases, 56 from the prenatal database and 47 from the clinicians, and 480 controls from the database. The two types of case did not differ in terms of age, weight, BMI or parity. Known risk factors were more common in cases than controls. In addition there was a 17-fold higher prevalence of cholelithiasis in cases compared with controls (29.1% versus 1.7%), a highly statistically significant difference (P < 0.0001). There was also an 8.8-fold increase among the mothers of cases and controls (P < 0.0001), and if either the patient or her mother had the disease the increase was 6.4-fold (P < 0.0001). Including the father or sibling did not increase the relative risk.
Conclusion:
Cholelithiasis is a clinical risk factor for preeclampsia which has not previously been reported. If confirmed by additional studies it may have utility in routine prenatal screening and provide insight into the pathogenesis of preeclampsia.
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