Genetic factors have long been suspected of being
responsible for at least part of the etiology, based on
familial aggregation and twin studies. To what extent
maternal, fetal or maternal-fetal genetic interaction is
responsible is not clear. As yet, no genes have been
replicated with sufficient statistical significance. A
large number of biomarkers have been associated with
pre-eclampsia, but there is not yet any established
predictive model based on data from the first half of
pregnancy that can be used clinically with any great
precision. Some of these associated biomarkers may
point us towards genes or environmental exposures of
etiological significance, but many of them are presumably
only downstream consequences of the many
metabolic alterations induced by pre-eclampsia.