- Objective: The objective of this study was to determine the profiles of maternal plasma soluble adhesion molecules in patients with preeclampsia, small-for-gestational-age (SGA) fetuses, acute pyelonephritis, preterm labor with intact membranes (PTL), preterm prelabor rupture of the membranes (preterm PROM), and fetal death. Materials and methods: A cross-sectional study was conducted to determine maternal plasma concentrations of sE-selectin, sL-selectin, and sP-selectin as well as sICAM-1, sVCAM-1, and sPECAM-1 in patients with 1) an uncomplicated pregnancy (control, n = 100); 2) preeclampsia (n = 94); 3) SGA fetuses (in women without preeclampsia/hypertension, n = 45); 4) acute pyelonephritis (n = 25); 5) PTL (n = 53); 6) preterm PROM (n = 24); and 7) fetal death (n = 34). Concentrations of soluble adhesion molecules and inflammatory cytokines (tumor necrosis factor (TNF)-α and interleukin (IL)-8) were determined with sensitive and specific enzyme-linked immunoassays. Results: In comparison to women with a normal pregnancy, 1) women with preeclampsia had higher median concentrations of sE-selectin, sP-selectin, and sVCAM-1, and a lower concentration of sL-selectin (all p-values < 0.001); 2) patients with SGA fetuses had higher median concentrations of sE-selectin, sP-selectin, and sVCAM-1 (all p-values < 0.05); 3) patients with a fetal death had higher median concentrations of sE-selectin and sP-selectin (all p-values < 0.05); 4) patients with acute pyelonephritis had higher median plasma concentrations of sE-selectin, sICAM-1, and sVCAM-1 (all p-values < 0.001); 5) patients with preeclampsia and acute pyelonephritis, plasma concentrations of sVCAM-1, sE-selectin, and sP-selectin correlated with those of the proinflammatory cytokines TNF-α and interleukin (IL)-8 (all p-values < 0.05); 6) patients with PTL had a higher median concentration of sP-selectin and a lower median concentration of VCAM-1 (all p-values < 0.05); and 7) women with preterm PROM had lower median concentrations of sL-selectin and sVCAM-1 (all p-values < 0.05). Conclusions: The results of this study show that endothelial cell activation/dysfunction reflected by the plasma concentration of sE-selectin is not specific to preeclampsia but is present in pregnancies complicated by SGA fetuses, acute pyelonephritis, and fetal death. Collectively, we report that each obstetrical syndrome appears to have a stereotypical profile of soluble adhesion molecules in the peripheral circulation.