Imbalanced matrix metalloproteinase (MMP) expression, including MMP-2, has been demonstrated in pre-eclampsia. However, little is known about the effect of polymorphisms in MMP-2 gene on hypertensive disorders of pregnancy. We examined whether two functional MMP-2 polymorphisms (g.-1306C>T and g.-735C>T) are associated with pre-eclampsia and/or gestational hypertension and whether these polymorphisms affect therapeutic responses in women with these conditions. We studied 216 healthy pregnant women (HP), 185 patients with gestational hypertension (GH) and 216 patients with pre-eclampsia (PE). They were stratified as responsive or non-responsive to antihypertensive therapy according to clinical and laboratorial parameters of therapeutic responsiveness. Genomic DNA was extracted from whole blood and genotypes for g-1306C>T and g.-735C>T polymorphisms were determined by real-time PCR using Taqman allele discrimination assays. Haplotype frequencies were inferred using the PHASE 2.1 program. The distributions of MMP-2 genotypes and haplotypes were similar in HP, GH and PE patients (p > 0.05). In addition, we found no significant differences in MMP-2 genotype or haplotype frequencies when GH or PE patients were classified as responsive or non-responsive to antihypertensive therapy (p > 0.05). Our results suggest that MMP-2 polymorphisms do not affect the susceptibility to hypertensive disorders of pregnancy. In parallel, MMP-2 polymorphisms apparently do not affect the responsiveness to antihypertensive therapy of women with these hypertensive disorders of pregnancy.Pre-eclampsia is a fairly common clinical condition characterized by new-onset hypertension and proteinuria during pregnancy, probably as a result of inadequate trophoblast invasion of the maternal uterine spiral arteries and poor placental perfusion [1]. Reduced blood flow promotes placental release of vasopressors [2], oxidative stress and pro-inflammatory alterations leading to vascular dysfunction [3].Matrix metalloproteinases (MMPs) are a family of structurally related, zinc-dependent enzymes with multiple functions and tissue distribution. Their activity target extracellular matrix components during development and morphogenesis [4]. Specifically, MMP-2 is involved in remodelling of placental and uterine arteries [5,6], and abnormal MMP-2 expression has been reported in hypertensive disorders of pregnancy [7][8][9][10].Under normal circumstances, MMP-2 activity is regulated at the level of transcription, activation of latent forms and inhibition by endogenous MMP inhibitors (tissue inhibitors of metalloproteinase; TIMPs) [4]. In this respect, two functional MMP-2 genetic polymorphisms apparently affect MMP-2 transcriptional levels: the g.-1306C>T and the g.-735C>T. In vitro studies showed that the 'C' to 'T' substitutions at 1306 and 735 positions in promoter region of MMP-2 gene, respectively, result in increased MMP-2 transcription [11,12]. Interestingly, while both polymorphisms have been associated with hypertension-related complications...