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This is my final draft edit for the preeclampsia page. I posted this to the preeclampsia page. I didn't get any feedback but one of the editors of the page moved my addition from the evolutionary considerations headline to be a part of the pathogenesis section. My two paragraphs are the last ones under that section in case anyone can't find them.

One hypothesis for vulnerability to preeclampsia is the maternal-fetal conflict between the maternal organism and fetus^[1]. After the first trimester trophoblasts enter the spiral arteries of the mother to alter the spiral arteries and thereby gain more access to maternal nutrients^[1]. However, occasionally there is impaired trophoblast invasion that results in inadequate alterations to the uterine spiral arteries^[1]. It is hypothesized that the developing embryo releases biochemical signals that result in the woman developing hypertension and preeclampsia so that the fetus can benefit from a greater amount of maternal circulation of nutrients due to increased blood flow to the impaired placenta^[1]. This results in a conflict between the maternal organism’s Darwinian fitness and survival and the developing fetus because the fetus is invested in only its survival and fitness while the mother is invested in this pregnancy and subsequent potential pregnancies^[1].

Another evolutionary hypothesis for vulnerability to preeclampsia is the idea of ensuring pair-bonding between the mother and father and paternal investment in the fetus^[2]. Researchers posit the idea that preeclampsia serves as an adaptation for the mother to terminate investment in a fetus that might have an unavailable paternal donor, as determined by repeated semen exposure of the paternal donor to the mother^[2]. Various studies have shown that women who frequently had exposure to partners’ semen before conception had a reduced risk of preeclampsia^[2]. Also, subsequent pregnancies by the same paternal donor had a reduced risk of preeclampsia while subsequent pregnancies by a different paternal donor had a higher risk of developing preeclampsia^[2].

References

^ ^a ^b ^c ^d ^e Redman, C. W.; Sargent, I. L. (2005). "Latest Advances in Understanding Preeclampsia". Science. 308 (5728): 1592–1594. doi:10.1126/science.1111726. PMID 15947178.
^ ^a ^b ^c ^d Davis, J. A.; Gallup, G. G. J. (2006). "Preeclampsia and other pregnancy complications as an adaptive response to unfamiliar semen". In Platek, Steven M; Shackelford, Todd K (eds.). Female Infidelity and Paternal Uncertainty. p. 191. doi:10.1017/CBO9780511617812.010. ISBN 9780511617812.

[Redman2005-1] Redman, C. W.; Sargent, I. L. (2005). "Latest Advances in Understanding Preeclampsia". Science. 308 (5728): 1592–1594. doi:10.1126/science.1111726. PMID 15947178.

[Davis2006-2] Davis, J. A.; Gallup, G. G. J. (2006). "Preeclampsia and other pregnancy complications as an adaptive response to unfamiliar semen". In Platek, Steven M; Shackelford, Todd K (eds.). Female Infidelity and Paternal Uncertainty. p. 191. doi:10.1017/CBO9780511617812.010. ISBN 9780511617812.

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