Maternal soluble suppression of Tumorigenicity-2 as a biomarker for fetal growth restriction: Clinical correlations...

To investigate maternal serum levels of soluble suppression of tumorigenicity-2 (sST2) in pregnancies complicated by fetal growth restriction (FGR), and to evaluate its diagnostic utility and association with adverse neonatal outcomes.

This prospective observational study comprised 88 singleton pregnancies, including 44 FGR cases and 44 healthy controls matched for gestational age. FGR was classified as early or late onset using Delphi consensus criteria. Maternal serum sST2 levels were measured between 28 and 37 weeks of gestation by ELISA. Correlation analyzes and ROC curve analyzes were performed to evaluate diagnostic performance and associations with clinical parameters.

sST2 levels were significantly higher in the FGR group compared to controls (p = 0.008). In the control group, sST2 levels showed a strong positive correlation with gestational age (r = 0.631, p < 0.001), no such correlation was observed in FGR pregnancies (r = 0.098, p = 0.529). ROC analysis demonstrated moderate diagnostic accuracy of sST2 for FGR (AUC = 0.665, p = 0.004), with high sensitivity (98 %) at a low cut-off (>0.28 ng/ml) and a specificity that reached 90 % at higher thresholds. sST2 also predicted adverse composite neonatal outcomes in FGR cases with an AUC of 0.689.

Maternal serum sST2 levels are significantly elevated in FGR pregnancies and may serve as a biomarker for placental dysfunction. Although the sST2 level is not specific enough as a stand-alone diagnostic tool, it can help in risk stratification when used in conjunction with other clinical or biochemical markers.