Quercetin as a promising phytotherapeutic candidate in preeclampsia: a narrative review

Authors

  • Ruby Aggarwal ICMR-National Institute of Child Health and Development Research (ICMR-NICHDR), Safdarjung Hospital Campus, New Delhi, India
  • Gargee Dutta Netes Institute of Pharmaceutical Science, Mirza, Guwahati, Assam, India
  • Aakansha Pathak ICMR-National Institute of Child Health and Development Research (ICMR-NICHDR), Safdarjung Hospital Campus, New Delhi, India
  • Archana Mishra Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital, New Delhi, India
  • Lakshyajeet Nath Netes Institute of Pharmaceutical Science, Mirza, Guwahati, Assam, India
  • Neeraj Kumar ICMR-National Institute of Child Health and Development Research (ICMR-NICHDR), Safdarjung Hospital Campus, New Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20261310

Keywords:

Preeclampsia, Treatment, Management, Quercetin

Abstract

Preeclampsia, a pregnancy specific hypertensive disorder, is one of the major cause of maternal and fetal morbidity and mortality globally. It occurs after 20 weeks of gestational period with high blood pressure and proteinuria, primarily caused by abnormal placental development with impaired endothelial function, and widespread inflammation. Current treatment strategies focus on the management of clinical symptoms of this disorder by using pharmaceutical agents like aspirin, Methyldopa, labetalol, hydralazine or nifedipine. But, these drugs cause various adverse effects on pregnancy due to which the researchers have started to explore the potential of several natural bioactive phytoconstituents to discover a safer and healthy alternative. One of these compounds is quercetin, a flavonol that exhibits significant antioxidant, anti-inflammatory, and immune-regulating properties. Preclinical studies have revealed that it helps in maintaining endothelial balance by regulating many inflammatory mediators. Different innovative delivery methods such as nanoparticles and liposomes are being developed to improve its efficacy as a natural therapeutic. The present review will provide insight into the immunology of preeclampsia along with its management by using a multi- targeted and safe natural therapeutic agent i.e. quercetin which in future may be used as an augmented therapy aimed at improving the both maternal and child health.

References

Shamsi U, Saleem S, Nishter N, Ameen A. Epidemiology and risk factors of preeclampsia: an overview of observational studies. Al Ameen J Med Sci. 2013;6(4):292-300.

Michalczyk M, Celewicz A, Celewicz M, Woźniakowska Gondek P, Rzepka R. The role of inflammation in the pathogenesis of preeclampsia. Mediators Inflamm. 2020;2020:3864941.

Shandilya V, Sinha N, Rani S. Preeclampsia: prevalence, risk factors, and impact on mother and fetus. Indian J Cardiovasc Dis Women. 2023;8(3):193-9.

Harutyunyan A, Armenian H, Petrosyan V. Interbirth interval and history of previous preeclampsia: a case–control study among multiparous women. BMC Pregnancy Childbirth. 2013;13:244.

Zhang Y, Diao Z, Su L, Sun H, Li R, Cui H, et al. MicroRNA-155 contributes to preeclampsia by down-regulating CYR61. Am J Obstet Gynecol. 2010;202(5):466.e1-e7.

Janani F, Changaee F. Seasonal variation in the prevalence of preeclampsia. J Family Med Prim Care. 2017;6(4):766-9.

Peng X, Oluchi-Amaka IC, Kwak-Kim J, Yang X.A comprehensive review of the roles of T-cell immunity in preeclampsia. Front Immunol. 2025;16:1476123.

Shahgheibi S, Rezaie M, Kamangar TM, Zarea S, Yousefi SR. The effect of season on the prevalence of preeclampsia. J Clin Gynecol Obstet. 2016;5(3):81-4.

Saito S, Shiozaki A, Nakashima A, Sakai M, Sasaki Y. The role of the immune system in preeclampsia. Mol Aspects Med. 2007;28(2):192-209.

Orefice R. Immunology and the immunological response in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2021;76:3-12.

Tranquilli AL, Dekker G, Magee L, Roberts J, Sibai BM, Steyn W, et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: a revised statement from the ISSHP. Pregnancy Hypertens. 2014;4(2):97-104.

Wiciński M, Malinowski B, Puk O, Socha M, Słupski M. Methyldopa as an inductor of postpartum depression and maternal blues: a review. Biomed Pharmacother. 2020;127:110196.

Xie J, Zhang AH, Sun H, Yan GL, Wang XJ. Recent advances and effective strategies in the discovery and applications of natural products. RSC Adv. 2018;8(2):812-24.

Sugulle M, Fiska BS, Jacobsen DP, Fjeldstad HE, Staff AC. Placental senescence and the two-stage model of preeclampsia. Am J Reprod Immunol. 2024;92(1):e13904.

Lesjak M, Beara I, Simin N, Pintać D, Majkić T, Bekvalac K, et al. Antioxidant and anti-inflammatory activities of quercetin and its derivatives. J Funct Foods. 2018;40:68-75.

Li Q, Yin L, Si Y, Zhang C, Meng Y, Yang W. The bioflavonoid quercetin improves pathophysiology in a rat model of preeclampsia. Biomed Pharmacother. 2020;127:110122.

Popiolek Kalisz J, Fornal E. The effects of quercetin supplementation on blood pressure—meta-analysis. Curr Probl Cardiol. 2022;47(11):101350.

Abbas M, Saeed F, Anjum FM, Afzaal M, Tufail T, Bashir MS, et al. Natural polyphenols: an overview. Int J Food Prop. 2017;20(8):1689-99.

Mlcek J, Jurikova T, Skrovankova S, Sochor J. Quercetin and its anti-allergic immune response. Molecules. 2016;21(5):623.

Xu D, Hu MJ, Wang YQ, Cui YL. Antioxidant activities of quercetin and its complexes for medicinal application. Molecules. 2019;24(6):1123.

Huang H, Liao D, Dong Y, Pu R. Effect of quercetin supplementation on plasma lipid profiles, blood pressure, and glucose levels: a systematic review and meta-analysis. Nutr Rev. 2020;78(8):615-26.

Comalada M, Camuesco D, Sierra S, Ballester I, Xaus J, Gálvez J, et al. In vivo quercitrin anti-inflammatory effect involves release of quercetin, which inhibits inflammation through down-regulation of the NF-κB pathway. Eur J Immunol. 2005;35(2):584-92.

Chaouat G, Petitbarat M, Dubanchet S, Rahmati M, Ledée N. Tolerance to the foetal allograft? Am J Reprod Immunol. 2010;63(6):624-36.

Aneman I, Pienaar D, Suvakov S, Simic TP, Garovic VD, McClements L. Mechanisms of key innate immune cells in early and late onset preeclampsia. Front Immunol. 2020;11:1864.

Chaparro A, Monckeberg M, Realini O, Hernández M, Param F, Albers D, et al. Gingival crevicular placental alkaline phosphatase is an early pregnancy biomarker for preeclampsia. Diagnostics. 2021;11(4):661.

Bonney EA. Alternative theories: pregnancy and immune tolerance. J Reprod Immunol. 2017;123:65-71.

Vivier E, Artis D, Colonna M, Diefenbach A, Di Santo JP, Eberl G, et al. Innate lymphoid cells: 10 years on. Cell. 2018;174(5):1054-66.

Guerin LR, Moldenhauer LM, Prins JR, Bromfield JJ, Hayball JD, Robertson SA et al. Seminal fluid regulates accumulation of FOXP3+ regulatory T cells in the preimplantation mouse uterus. Biol Reprod. 2011;85(2):397-408.

Robertson SA, Care AS, Moldenhauer LM. Regulatory T cells in embryo implantation and the immune response to pregnancy. J Clin Invest. 2018;128(10):4224-35.

Faas MM, de Vos P. Maternal monocytes in pregnancy and preeclampsia in humans and in rats. J Reprod Immunol. 2017;119:91-7.

Abu-Raya B, Michalski C, Sadarangani M, Lavoie PM. Maternal immunological adaptation during normal pregnancy. Front Immunol. 2020;11:575197.

Redman CWG, Sargent IL. Placental stress and pre-eclampsia: a revised view. Placenta. 2009;30(A):S38-42.

Sah A, Naseef PP, Kuruniyan MS, Jain GK, Zakir F, Aggarwal G. A comprehensive study of therapeutic applications of chamomile. Pharmaceuticals (Basel). 2022;15(10):1284.

Yao J, Long H, Zhao J, Zhong G, Li J. Nifedipine inhibits oxidative stress and ameliorates osteoarthritis. Life Sci. 2020;253:117292.

Odigboegwu O, Pan LJ, Chatterjee P. Use of antihypertensive drugs during preeclampsia. Front Cardiovasc Med. 2018;5:50.

Rolnik DL, Nicolaides KH, Poon LC. Prevention of preeclampsia with aspirin. Am J Obstet Gynecol. 2022;226(2 Suppl):S1108-19.

Celec P. Nuclear factor kappa B—molecular biomedicine: the next generation. Biomed Pharmacother. 2004;58(6-7):365-71.

Atallah A, Lecarpentier E, Goffinet F, Doret-Dion M, Gaucherand P, Tsatsaris V. Aspirin for prevention of preeclampsia. Drugs. 2017;77(17):1819-31.

Yang S, Song L, Shi X, Zhao N, Ma Y. Ameliorative effects of preeclampsia by quercetin supplement to aspirin. Biomed Pharmacother. 2019;116:108969.

Ożarowski M, Mikołajczak PŁ, Kujawski R, Wielgus K, Klejewski A, Wolski H, et al. Pharmacological effect of quercetin in hypertension. Evid Based Complement Alternat Med. 2018;2018:7421489.

Bralewska M, Rybak-Krzyszkowska M, Grzesiak M, Pietrucha T. New ideas for the prevention and treatment of preeclampsia. Int J Mol Sci. 2023;24(15):12100.

Sánchez M, González-Burgos E, Iglesias I, Lozano R, Gómez-Serranillos MP. Pharmacological activity of Camellia sinensis. Biomolecules. 2020;10(4):603.

Stainer AR, Sasikumar P, Bye AP, Unsworth AJ, Holbrook LM, Tindall M, et al. Metabolites of quercetin possess potent antithrombotic activity. TH Open. 2019;3(3):e244-58.

Widyaningrum SA, Wasita B, Nuhriawangsa AM. Levels of quercetin and antioxidant activity of Patikan Kebo leaves extract. In: Proc 4th Int Conf Soc Determinants Health. 2022;89-93.

Salvamani S, Gunasekaran B, Shaharuddin NA, Ahmad SA, Shukor MY. Antiartherosclerotic effects of plant flavonoids. Biomed Res Int. 2014;2014:480258.

Sidor A, Gramza-Michałowska A. Elderberry health benefits. J Funct Foods. 2015;18:941-58.

Kashyap P, Kumar S, Riar CS, Baniwal P, Guiné RP, Correia PM, et al. Advances in Moringa oleifera leaves bioactives. Antioxidants (Basel). 2022;11(2):402.

Michala AS, Pritsa A. Quercetin: biochemical and clinical value. Diseases. 2022;10(3):37.

Tain YL, Hsu CN. Maternal polyphenols and offspring health. Nutrients. 2024;16(18):3168.

Cao L, Tan C, Meng F, Liu P, Reece EA, Zhao Z. Quercetin reduces neural tube defects. Sci Rep. 2016;6:21491.

Bolouki A, Zal F, Mostafavi Pour Z, Bakhtari A. Protective effects of quercetin in diabetic pregnancy. Taiwan J Obstet Gynecol. 2020;59(6):927-34.

David AVA, Arulmoli R, Parasuraman S. Biological importance of quercetin. Pharmacogn Rev. 2016;10(20):84-9.

Li Y, Yao J, Han C, Yang J, Chaudhry MT, Wang S, et al. Quercetin, inflammation and immunity. Nutrients. 2016;8(3):167.

Hashemzaei M, Delarami Far A, Yari A, Heravi RE, Tabrizian K, Taghdisi SM, et al. Anticancer effects of quercetin. Oncol Rep. 2017;38(2):819-28.

Costa PCT da, de Souza EL, Lacerda DC, Cruz Neto JP, Sales LC, Silva Luis CC, et al. Quercetin in cardiometabolic diseases in pregnancy. Foods. 2022;11(18):2772.

Zhang W, Zheng Y, Yan F, Dong M, Ren Y. Research progress of quercetin in cardiovascular disease. Front Cardiovasc Med. 2023;10:1203713.

Ansari P, Choudhury ST, Seidel V, Rahman AB, Aziz MA, Richi AE, et al. Therapeutic potential of quercetin in type 2 diabetes mellitus. Life. 2022;12(8):1146.

Meseret AA, Wondimagegne ZT. Predictive factors of undernutrition in diabetes. J Nutr Sci. 2025;14:e32.

Jagru P, Natarajan SB, Shanmugam N, Perera T, Parameswaran SK. Phytochemicals in diabetic neuropathy. Int J Food Drug Cosmet. 2025;1(2):16-38.

Yang S, Song L, Shi X, Zhao N, Ma Y. Quercetin supplement to aspirin in preeclampsia. Biomed Pharmacother. 2019;116:108969.

Vangrieken P, Al Nasiry S, Bast A, Leermakers PA, Tulen CB, Janssen GM, et al. Hypoxia-induced mitochondrial abnormalities in placenta. PLoS One. 2021;16(1):e0245155.

Yang S, Zhang J, Chen D, Ding J, Zhang Y, Song L. Quercetin attenuates L-NAME-induced preeclampsia-like impairments. Drugs R D. 2022;22(4):271-9.

Yoshida K, Kusama K, Shinohara G, Sato S, Yoshie M, Tamura K . Quercetin stimulates trophoblast fusion. Sci Rep. 2024;14(1):287.

Ding J, Yang S, Chen D, Shi X, Zhang Y, Song L, et al. Protective effects of aspirin with quercetin. Physiol Res. 2024;73(1):37-45.

Vangrieken P, Al Nasiry S, Remels AHV, Schiffers PM, Janssen E, Nass S, et al. Placental methylglyoxal in preeclampsia. Hypertension. 2024;81(7):1537-49.

Shi M, Sun L, Wei J, Shen Y, Wang J, Zhang P, et al. Quercetin alleviates endothelial dysfunction. Commun Biol. 2025;8(1):90.

Nguyen PY, Sanderson B, Makama M, Mills K, Ammerdorffer A, Gülmezoglu AM, et al. Polyphenols for preeclampsia prevention. BJOG. 2025;132(7).

Ahnemaei FA, Fashami MA, Abdi F, Abbasi M. Factors preventing preeclampsia. Taiwan J Obstet Gynecol. 2020;59(2):173-82.

Ahn H, Park J, Gilman-Sachs A, Kwak-Kim J. Immunologic characteristics of preeclampsia. Am J Reprod Immunol. 2011;65(4):377-94.

Brennan LJ, Morton JS, Davidge ST. Vascular dysfunction in preeclampsia. Microcirculation. 2014;21(1):4-14.

Liu W, Zhang M, Feng J, Fan A, Zhou Y, Xu Y. Influence of quercetin on maternal immunity during gestation. Int J Environ Res Public Health. 2017;14(6):592.

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Published

2026-04-28

How to Cite

Aggarwal, R., Dutta, G., Pathak, A., Mishra, A., Nath, L., & Kumar, N. (2026). Quercetin as a promising phytotherapeutic candidate in preeclampsia: a narrative review. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 15(5), 1890–1899. https://doi.org/10.18203/2320-1770.ijrcog20261310

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Review Articles