Review: Biochemical markers to predict preeclampsia

Area of Science:

• Obstetrics and Gynecology
• Biochemistry
• Maternal-Fetal Medicine

Background:

• Preeclampsia (PE) affects 3-8% of pregnancies globally, causing significant maternal and fetal mortality.
• No specific treatment exists for PE, highlighting the need for early detection and prediction.
• Reliable biochemical markers are crucial for improving maternal health outcomes and managing PE.

Purpose of the Study:

• To review general and first-trimester biochemical markers for preeclampsia prediction and diagnosis.
• To discuss the potential of specific markers including angiogenic factors, placental proteins, and kidney markers.
• To evaluate the efficacy of markers like PAPP-A, HbF, s-Flt-1/PlGF, and A1M.

Main Methods:

• Review of existing literature on preeclampsia biochemical markers.
• Analysis of specific markers such as PAPP-A, HbF, s-Flt-1/PlGF, s-Endoglin, PP13, cystatin-C, and α₁-microglobulin (A1M).
• Assessment of marker sensitivity, specificity, and optimal timing for detection (e.g., first trimester, mid-second trimester).

Main Results:

• PAPP-A and HbF show potential for first-trimester PE prediction (70% sensitivity, 95% specificity).
• PAPP-A requires combination with Doppler ultrasound for sensitivity comparable to HbF/A1M.
• Soluble Flt-1/PlGF demonstrate high sensitivity from the mid-second trimester; PlGF is useful from late first trimester.

Conclusions:

• Biochemical marker screening can reduce healthcare costs and improve maternal outcomes through early PE detection.
• Early identification of high-risk pregnancies allows for optimized monitoring and timely delivery, potentially reducing premature births.
• Combining markers and ultrasound may enhance diagnostic accuracy for preeclampsia.