Placental caspase-3 expression in preeclampsia: a systematic review of observational evidence.

Authors

Graciella Angelica Lukas, Wisnu Prabowo, Annisa Aghnia Rahma, Maurilla Iascha Suhartono, Hidayat Fatahillah, Hikam Yanwar Pradana, Muhana Fawwazy Ilyas, Matthew Aldo Wijayanto

Published in

Obstetrics & gynecology science. Oct 08, 2026. Epub Oct 08, 2026.

Abstract

Preeclampsia is a pregnancy disorder that contributes substantially to maternal and fetal morbidity and mortality worldwide. Apoptosis has been implicated in its pathogenesis, particularly in placental dysfunction. Caspase-3, an executioner caspase, mediates the final stage of apoptotic signaling; however, its role in preeclampsia remains incompletely defined. This systematic review evaluated observational evidence on placental caspase-3 expression in preeclampsia. PubMed, Scopus, and ScienceDirect were systematically searched on June 21, 2024. Eligible studies were human observational studies that assessed caspase-3 expression in placental tissue from pregnancies complicated by preeclampsia. Risk of bias was evaluated using the Newcastle-Ottawa Scale and the Risk of Bias Assessment Tool for Nonrandomized Studies 2.0 (RoBANS 2.0; COMPANY, CITY, STATE, COUNTRY). Data were synthesized qualitatively because of substantial methodological heterogeneity. Twelve studies (n=736 pregnancies) were included. All assessed caspase-3 expression in placental tissue obtained after delivery. Most reported higher caspase-3 expression in preeclamptic placentas than in normotensive controls, particularly in early-onset and severe preeclampsia. However, the studies varied substantially in diagnostic subtypes, measurement methods (including immunohistochemistry scoring systems, Western blotting, and enzyme-linked immunosorbent assay), and control of confounding variables. Observational evidence consistently indicates increased placental caspase-3 expression in preeclampsia, supporting enhanced apoptotic activity in affected placentas. However, because measurements were performed after delivery and caspase-3 is a downstream executioner caspase, current evidence supports its use as a marker of established placental injury. Further mechanistic and longitudinal studies are needed.

PMID:
42844893
Bibliographic data and abstract were imported from PubMed on 08 Oct 2026.

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