Cell-derived microparticles and vascular pregnancy complications: a systematic and comprehensive review

Objective: To assess current studies on the relationship between cell-derived microparticles (cMP) and recurrent miscarriages (RM) and pre-eclampsia (PE), and review the relationships between cMP and inflammatory and clot pathways, antiphospholipid antibodies (aPL), cytokines, and pregnancy complications. Design: Systematic and comprehensive review of the literature from January 2000 to January 2012. Setting: Vall d'Hebron University Hospital. Patient(s): Women with recurrent miscarriages or PE, healthy nonpregnant women, and healthy pregnant women. Intervention(s): None. Main Outcome Measure(s): Comparison of cMP numbers and types among groups. Result(s): Platelet and endothelial cMP are increased in women with normal pregnancies compared with nonpregnant healthy women. Only five case-control studies regarding cMP and RM and 16 on cMP and PE were found to match our objective. Three of five articles referring to RM showed differences in cMP numbering, and 13 of 16 on cMP and PE showed differences in some type of cMP compared with controls. Conclusion(s): Cell-derived microparticles were raised in normal pregnancy. Recurrent miscarriage seems to be related to endothelial and platelet cell activation and/or consumption. An increase in almost all cMP types was observed in PE. A relationship between cMP and endothelial activation and proinflammatory status seems to exist. (Fertil Steril (R) 2013; 99: 441-9. (C) 2013 by American Society for Reproductive Medicine.)