Barjaktarovic M, et al. - Given a possible association of abnormal placentation in early pregnancy with the pathogenesis of preeclampsia and that placental development and angiogenesis are regulated by human chorionic gonadotropin (hCG), researchers examined whether total hCG is associated with the risk of preeclampsia and whether pro- and anti-angiogenic factors affect this association. In this population-based prospective cohort study of 7,754 women with a singleton pregnancy, they performed measurement of total hCG in the first available sample (median gestational age, 14.4 weeks; 95% range, 10.1–26.1 weeks) and sFlt-1 and PlGF concentrations in early (< 18 weeks; median, 13.2 weeks; 95% range, 9.6–17.6 weeks) and in mid- (18–25 weeks; median, 20.4 weeks; 95% range, 18.5–23.5 weeks) pregnancy. The analysis revealed a correlation between high total hCG concentration in early pregnancy and an increased risk of preeclampsia. High hCG concentration affects the balance between pro- and anti-angiogenic factors during pregnancy and this may have a role in the pathophysiology of preeclampsia.