**5. Conclusions**

PE was found to be significantly predicted by low adiponectin and high leptin, resistin, and visfatin, with resistin being the greatest predictor when stratified by BMI categories. After controlling for age, parity, BMI, and family history of diabetes and preeclampsia, adiponectin was the greatest predictor.

Adiponectin concentration in patients with PE starts decreasing as early as 11 weeks of pregnancy and continues to decrease until after 24th weeks of pregnancy when proteinuria becomes apparent and blood pressure rises to an abnormal level and consequently, preeclampsia develops. The decrease in adiponectin contributes to the pathogenesis of PE and can be used to predict this disease.

Leptin concentration starts increasing by 11 weeks of pregnancy in patients who subsequently develop PE. The increase in leptin correlates with proteinuria and elevated systolic and diastolic blood pressure irrespective of maternal age and BMI and hence could be involved in the pathogenesis of GDM.

Resistin in pregnant women who go on to develop PE starts increasing between 11 and 13 weeks of gestation culminating in an excessive increase in blood pressure accompanied by proteinuria by 24 weeks of gestation when a diagnosis of PE becomes apparent.

Visfatin in pregnancies complicated by PE starts increasing during the first trimester of pregnancy and continues to increase until the second trimester when blood pressure increases resulting in the diagnosis of PE in women with concomitant proteinuria. This suggests that hypervisfatinemia can be used to predict hypertensive disorders during pregnancy and hence involved in the pathogenesis of PE.

Our findings suggest that BMI may have an effect on adiponectin, leptin, resistin, and visfatin, as well as a possible negative feedback mechanism in the metabolism of these adipocytokines during pregnancy. More importantly, BMI does not appear to have an effect on the predictive ability of these PE signaling molecules. Advanced maternal age was shown to be an important factor in the development of PE.

*Pathophysiology of Preeclampsia: The Role of Adiposity and Serum Adipokines DOI: http://dx.doi.org/10.5772/intechopen.104752*

These biomarkers can be used in combination with maternal characteristics for the early prediction of PE. This will help health care providers to institute measures such as diet control, medication, and exercises tailored for pregnant women with these risk factors so as to reduce the incidence of preeclampsia.
