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This review synthesizes their molecular, endocrine, immune, and clinical features. We propose the Placental-Maternal Adaptation Failure Continuum (PMAFC), in which gestational\/fetoplacental stress load interacts with maternal adaptive reserve. This load includes placenta-derived signals, the physiological demands of gestation and fetal growth, and secondary maternal or fetal mediators. Placental drive denotes the placenta-derived component, whereas maternal adaptive reserve reflects the capacity of vascular, metabolic, hepatic, neuroendocrine, and immune systems to compensate for pregnancy-related challenges. We distinguish experimentally derived mechanistic hypotheses from findings supported by human studies and consider persistent post-pregnancy changes, termed pregnancy memory, as a potential link to later maternal cardiometabolic risk. We also separate established care from investigational biomarkers and interventions. The soluble fms-like tyrosine kinase-1\/placental growth factor (sFlt-1\/PlGF) ratio can support clinical assessment in selected PE pathways. Cell-free RNA, chromosome 19 microRNA cluster biomarkers, and polygenic risk scores remain investigational. Apheresis has limited human proof-of-concept evidence, whereas sFlt-1 silencing, growth differentiation factor 15 receptor blockade, and strategies to restore hepatobiliary transporter function remain under clinical or preclinical evaluation. PMAFC is an evidence-organizing framework, not a validated predictive or therapeutic algorithm.<\/jats:p>","DOI":"10.1186\/s43556-026-00566-6","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:53:35Z","timestamp":1791820415000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pregnancy-related disorders: molecular mechanisms and management"],"prefix":"10.1186","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2375-8625","authenticated-orcid":false,"given":"Chehao","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deying","family":"Mou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huafeng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1735-5903","authenticated-orcid":false,"given":"Qian","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"issue":"2","key":"566_CR1","doi-asserted-by":"publisher","first-page":"89","DOI":"10.5830\/CVJA-2016-021","volume":"27","author":"P Soma-Pillay","year":"2016","unstructured":"Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. 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