Predictive values of multiple serum biomarkers in women with suspected preeclampsia: a prospective study

Abstract Background Early 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 with PE-related clinical and/or laboratory presentations were recruited and had the blood drawn at their first visits. The prospective cohort was further divided into the PE-positive and PE-negative groups based on the follow-up results. The following markers were tested with the collected serum samples: sFlt-1, PlGF, M, tPAI-C, compliment factors C1q, B, H, BUN, GlyFn, PAPP-A2, BUN, Cre, UA and Cysc. Results Totally 196 women suspected for PE were recruited with follow-up medical records. Twenty-five percent of the recruited subjects developed PE before delivery and 75% remained PE-negative. The serum levels of sFlt-1, BUN, Cre, UA, Cysc and PAPP-A2 were significantly elevated and the PlGF was significantly decreased in the PE-positive patients. The AUCs were listed in the order of decreasing values: UA (AUC = 0.73), sFlt-1/PlGF (AUC = 0.67), Cysc (AUC = 0.66), GlyFn/PlGF (AUC = 0.65), PlGF (AUC = 0.64), PAPP-A2/PlGF (AUC = 0.64), sFlt-1 (AUC = 0.63), BUN (AUC = 0.63), Cre (AUC = 0.63), and PAPP-A2 (AUC = 0.60) in the ROC analyses. The Logistic regression analysis showed that UA and PAPP-A2 were independent risk factors for PE development with the odds ratios of 3.3 and 2.2 respectively. Moreover, the PPVs of UA and PAPP-A2 were 48.9%, and 40.4%; the NPVs of UA and PAPP-A2 were 82.1% and 81.9%. Conclusions Further studies are warranted to confirm the clinical utilities of the serum markers in PE prediction.