During pregnancy, the mother-placenta relationship involves intricate and dynamic exchanges. Over the course of gestation, the maternal body encounters numerous fetal materials secreted by the placenta, such as hormones, growth factors, and extracellular vesicles like exosomes. These exosomes are carriers of key biomolecules, including proteins, lipids, nucleic acids (DNA), and microRNA (miRNA), capable of influencing maternal cellular activity. Although the exact functions of placental exosomes during pregnancy remain under investigation, existing research indicates that they contribute significantly to normal placental growth and maternal immune tolerance, both of which are vital for sustaining a healthy pregnancy. The involvement of exosomes in the etiology and progression of pregnancy complications is also under investigation. Variations in the quality and quantity of placenta-derived exosomes, their concentration in maternal plasma, and their composition and bioactivity have been linked to complications such as gestational diabetes, preeclampsia, and maternal infections. There is considerable interest not only in understanding the role of placenta-derived exosomes in both normal and complicated pregnancies but also in their potential as biomarkers and therapeutic targets. Progress in this field depends on using specific and well-characterized methodologies and techniques to precisely determine the role of exosomes in pregnancy complications and their clinical utility. This review emphasizes the significance of placenta-derived exosomes in pregnancy, focusing on their interaction with the maternal system. Additionally, it explores new techniques and ideas for analyzing placental exosomes as potential biomarkers for the early diagnosis of pregnancy complications.
Keywords: biomarker discovery; exosomes; gestational diabetes; immunomodulation; placental EVs; preeclampsia.