The frequency of development of hypertensive states in IDA reaches 32-45%. The pathogenesis of the combined complications of pregnancy with anemia and preeclampsia, including immunological aspects has been little studied. Purpose: to clarify the role of violations general and local cytokine status in pregnant women with anemia in the genesis of preeclampsia and justify the need to include immuno suppressants for the prevention and treatment of preeclampsia. Materials and methods: In 96 pregnant women with iron deficiency anemia (IDA) and preeclampsia in the third trimester of gestation the cytokine status of IL-1β, IL-6, IL-8, TNFα and lactoferrin in the serum of peripheral blood and in extracts of the placenta decidual tissue was examined by ELISA. Pregnant women were divided into 4 groups: 24-with mild anemia, 18-with moderate anemia, 26-with preeclampsia and with mild anemia and 28 pregnant women with preeclampsia and with moderate anemia. Results: It has been established that preeclampsia on the background of IDA is accompanied by a significant increase in the level of pro-inflammatory cytokines (p<0,05) and the acute phase protein lactoferrin (p<0,05) on the systemic and to a greater extent on the local level in the development of preeclampsia on the background of anemia of moderate severity (p<0,05). Discussion: The data obtained confirm the involvement of the immune system in the pathogenesis of preeclampsia, one of the trigger mechanisms of which is the immune imbalance in iron deficiency anemia. A pathogenetic rationale for the use of immunosuppressive therapy for combined pathology is given. Conclusion: The use of placental hormone - progesterone as an immunosuppressive drug in terms of substantiating new immunotherapy strategies for the prevention of preeclampsia is a topical trend in obstetric practice.