Abstract: Objective To investigate the relationship between the Ala379Val polymorphism of the platelet-activating factor acetylhydrolase gene (PAF-AH) and pre-eclampsia (PE) in Chinese pregnant women. Methods A total of 592 subjects (210 patients with PE and 382 healthy pregnant women) in Chengdu area were included in this study. The Ala379Val polymorphism of the PAF-AHgene was determined by PCR amplification and restriction analysis. Plasma PAF-AH and high-density lipoprotein-associated PAF-AH (H-PAF-AH) activities were measured by the trichloroacetic acid precipitation method using PAF as substrate and (³ H-acetyl) PAF as tracer. Low-density lipoprotein-associated PAF-AH (L-PAF-AH) activity was obtained by subtracting H-PAF-AH activity from plasma PAF-AH activity. Results The frequencies of the A and V alleles at Ala379Val site were 0.890 and 0.110 in the patient group, and 0.865 and 0.135 in control group, respectively. No significant differences in the frequencies of the genotypes and alleles were observed between the two groups (P >0.05). However, the body mass index (BMI) and the ratio of L-PAF-AH to H-PAF-AH activities were significantly higher, and H-PAF-AH activity was significantly lower, in patients with V alleles (AV + VV genotypes) compared to patients with AA homozygotes (P <0.05). Conclusion The Ala379Val polymorphism of the PAF-AH gene was not associated with PE, but the V allele variation at this site might be associated with the increased BMI and the abnormal distribution of plasma PAF-AH activities in lipoproteins in patients with PE.