Predictive values of various serum biomarkers in women with suspected preeclampsia: A prospective study

Abstract

Background

Preeclampsia (PE) prediction has been shown to improve the maternal and fetal outcomes in pregnancy. We aimed to evaluate the PE prediction values of a series of serum biomarkers.

Methods

The singleton pregnant women (20–36 gestational weeks) with PE‐related clinical and/or laboratory presentations were recruited and had the blood drawn at their first visits. The following markers were tested with the collected serum samples: soluble fms‐like tyrosine kinase 1 (sFlt‐1), placental growth factor (PlGF), thrombomodulin (TM), tissue plasminogen activator inhibitor complex (tPAI‐C), complement factors C1q, B, H, glycosylated fibronectin (GlyFn), pregnancy‐associated plasma protein‐A2 (PAPP‐A2), blood urea nitrogen (BUN), creatinine (Cre), uric acid (UA), and cystatin C (Cysc).

Results

Of the 196 recruited subjects, 25% ( n = 49) developed preeclampsia before delivery, and 75% remained preeclampsia negative ( n = 147). The serum levels of sFlt‐1, BUN, Cre, UA, Cysc, and PAPP‐A2 were significantly elevated, and the PlGF level was significantly decreased in the preeclampsia‐positive patients. In the receiver operating characteristics (ROC) analyses, the area under the curves were listed in the order of decreasing values: 0.73 (UA), 0.67 (sFlt‐1/PlGF), 0.66 (Cysc), 0.65 (GlyFn/PlGF), 0.64 (PAPP‐A2/PlGF), 0.63 (BUN), 0.63 (Cre), and 0.60 (PAPP‐A2). The positive predictive values of these serum markers were between 33.1% and 58.5%, and the negative predictive values were between 80.9% and 89.5%.

Conclusions

The serum markers investigated in current study showed better performance in ruling out than ruling in PE. Absence of pre‐defined latency period between blood draw and the onset of PE limits the clinical utility of these markers.

Abstract

In present study, we evaluated the predictive values of the following serum biomarkers in a prospective study with the women suspected to develop preeclampsia (PE): soluble fms‐like tyrosine kinase 1 (sFlt‐1), placental growth factor (PlGF), pregnancy‐associated plasma protein‐A2 (PAPP‐A2), glycosylated fibronectin (GlyFn), thrombomodulin (TM), tissue plasminogen activator inhibitor complex (tPAI‐C), uric acid (UA), blood urea nitrogen (BUN), creatinine (Cre), and cystatin C (Cysc). The graphical image showed the ROC analyses of the serum markers for PE prediction in the prospective cohort with PE‐related clinical or laboratory presentations. A. ROC analyses for sFlt‐1 and sFlt‐1/PlGF; B. BUN, Cre, UA, and Cysc; C. PAPP‐A2, GlyFn/PlGF and PAPP‐A2/PlGF; D. PlGF.