Multi-omics of chorionic villus samples reveals early pregnancy placental dysfunction associated with preeclampsia

Preeclampsia is a serious pregnancy-induced disorder unique to humans affecting 4.6% of pregnancies worldwide. Advances in the detection, prevention and treatment of preeclampsia have been poor due to our inadequate understanding of its pathogenesis. Here, we perform a multiomics study on early pregnancy placental biopsies (chorionic villus samples) from pregnancies that developed preterm and term preeclampsia compared to normotensive controls. Using an integrative multivariate approach, we uncovered distinct molecular signatures: preterm preeclampsia was strongly associated with dysregulated lipoprotein metabolism, while term preeclampsia exhibited alterations in inflammatory pathways, notch signaling and ribosome assembly. These results challenge the prevailing notion that term preeclampsia is unrelated to early placental pregnancy dysfunction. Our study provides critical insights into the early pregnancy aberrations underlying both preterm and term preeclampsia, paving the way for novel predictive biomarker and targeted preventative treatments. This work represents a significant step towards unravelling the complex etiology of preeclampsia and improving maternal and perinatal health outcomes.