The relationship of smoking, preeclampsia, and secretory component

Objective: We sought to determine whether total secretory component in serum is increased in women in whom preeclampsia subsequently develops. Study Design: Serum samples were collected serially throughout pregnancy and post partum from nulliparous women (N = 1496). Serum concentrations of total secretory component were measured by an enzyme-linked immunosorbent assay in all women in whom preeclampsia developed (n = 71) and a randomly selected group of normotensive women (n = 83). Results: Secretory component increased with smoking (P = .0003) and with gestation (P = .0001). In the whole group secretory component was not different in women with preeclampsia (P = .10), but there was a significant interaction of smoking, gravidity, and preeclampsia (P = .04). Among the women who smoked, secretory component was lower in women in whom preeclampsia subsequently developed compared with those who remained normotensive (P = .02). This difference was significant from 15 to 19 weeks’ gestation. Conclusion: Very high serum concentrations of secretory component in smokers may protect against the development of preeclampsia and may indicate the involvement of mucosal tolerance. (Am J Obstet Gynecol 2000;183:136-9.)