Purpose: Delineate whereas ADAM-12 levels at first trimester of pregnancy may be used as a marker for hypertension-preeclampsia (PE) and intrauterine growth restriction (IUGR). Materials and Methods: The present is a case control study. Serum ADAM-12 of women presenting for routine assessment of risk for chromosomal abnormalities at 11+0 to 13+6 weeks of gestation was measured. The study group comprised of 98 pregnancies that subsequently developed pregnancy-induced hypertension (PIH) or PE or small for gestational age fetuses (SGA), and were compared to 100 uncomplicated pregnancies. Results: There was no statistically significant difference of mean log multiple of the expected median (MoM) of ADAM12 between control group and the group that consisted of all women with complicated pregnancy (PE, PIH, and SGA). ADAM-12 levels in women who developed PE during pregnancy were significantly lower than in women of control group (mean log MoM: 0.109 vs 0.008, p = 0.010). Similarly, ADAM-12 levels in women who developed PE and/or PIH were significantly lower than in women of control group (mean log MoM: 0.066 vs 0.008, p = 0.015). There was no significant difference of ADAM12 levels between controls and pregnancies with SGA fetuses. Conclusion: Maternal serum levels of ADAM-12 at the first trimester are significantly lower in women who later develop PE when compared with women with uncomplicated pregnancies.