Objective: Adiponectin is an exclusively adipose tissue- derivedprotein. Low plasma adiponectin levels have been found in hypertensive men. Our objective was to evaluate whether low first- trimester plasma adiponectin values were predictive of hypertensive disorders later in pregnancy. Methods: A nestedcase- control studywas carried out on a cohort of 1,842 pregnant women who participated in the first- trimester Down syndrome screening program; 34 developed preeclampsia and 48 gestational hypertension. A control group of 82 nonhypertensive uneventful pregnancies was selected. Plasma adiponectin was determined using an enzyme- linked immunosorbent assay (ELISA).Results: Adiponectin median concentrations in the group which subsequently became hypertensive were significantly lower than those in the control group (7.6 versus 13.0μ g/mL) (P < .001). When the 2 hypertensive subgroups were considered, the plasma adiponectin median value in the preeclampsia group was significantly lower than that in the gestational hypertension group (6.6 versus 9.3 μ g/mL) (P = .01). Regression analysis showed an inverse correlation between plasma adiponectin concentrations and maternal age,gestational age, body mass index, systolic blood pressure, andproteinuria. Approximately 34% of hypertensive pregnancies,compared with 7% of controls (P < .001), had plasma adiponectin concentrations less than 6.4 μ g/mL (mean value of lower quartile of distribution among control patients). After adjusting for maternal age, all these women experienceda 6.6- fold (95% confidence interval 2.5- 17.8) increased risk of pregnancy hypertension, compared with those women who had higher concentrations Conclusion: Our findings suggest astrong association between hypoadiponectinemia and the risk of hypertensive disorders in pregnancy,especially with preeclampsia. Objective: Adiponectin is an exclusively adipose tissue-derived protein. The objective of low plasma adiponectin levels have been found in hypertensive men. Our objective was to evaluate whether low first- trimester plasma adiponectin values ​​were predictive of hypertensive disorders later in pregnancy. Methods: A nested case-control studywas carried out on a cohort of 1,842 pregnant women who participated in the first-trimester Down syndrome screening program; 34 developed preeclampsia and 48 gestational hypertension. A control group of 82 nonhypertensive uneventful pregnancies was selected. Plasma adiponectin was determined using an enzyme-linked Results: Adiponectin median concentrations in the group which resulted became hypertensive were significantly lower than those in the control group (7.6 versus 13.0 μg / mL) (P <.001). When the 2 hypertensive subgroups were considered , the plasma adiponectin median value in the preeclampsia group was significantly lower than that in the gestational hypertension group (6.6 versus 9.3 μg / mL) (P = .01). Regression analysis showed an anomal correlation between plasma adiponectin concentrations and maternal age, gestational age, body mass index, systolic blood pressure, and proteininia. Approximately 34% of hypertensive pregnancies, compared with 7% of controls (P <.001), had plasma adiponectin concentrations less than 6.4 μg / mL (mean value of lower quartile of distribution among control patients). After adjusting for maternal age, all These women experienceda 6.6-fold (95% confidence interval 2.5- 17.8) increased risk of pregnancy hypertension, compared with those women who had high concentrations Conclusion: Our findings suggest astrong association between hypoadiponectinemia and the risk of hypertensive disorders in pregnancy, especially with preeclampsia .