Clinical value of urinary misfolded protein and serum markers in preeclampsia: a descriptive longitudinal study

The study assesses misfolded proteins & placental growth factor (PLGF) in preeclampsia (PE) prediction. Evaluate the Congo Red Dot (CRD) test & optimal gestational weeks for detection.

A prospective study collected urine and serum samples from 805 singleton pregnancies at Ningbo Women and Children's Hospital from January 1, 2022, to January 31, 2023. Misfolded proteins were detected using the CRD assay. Statistical analyses included Chi-square tests to compare the CRD positivity rates across different gestational weeks and between PE and healthy pregnancies, independent samples t-tests for serum PLGF levels, and multiple logistic regression to assess factors influencing PE occurrence.

The highest positivity rates for misfolded proteins occurred between 14 and 20⁺⁶ weeks of gestation. The prevalence of preterm delivery and urine protein ≥ 2 + was higher among PE patients. The CRD test had higher true positive rates in the preterm group and a higher false positive rate in women with urine protein ≥ 2 + . We describe the longitudinal behaviour of CRD and PLGF across gestation in women who later developed PE versus those who remained normotensive.

CRD positivity is most frequently observed between 14 and 27⁺⁶ weeks' gestation; serial measurements provide descriptive insight into the trajectory of urinary misfolded proteins, and concurrent PLGF trends are reported for comparative reference.