Serum sPD-L1 Levels in Early Pregnancy Predict Fetal Growth Restriction and Its Subtypes: A Prospective Nested...

Area of Science:

• Reproductive biology
• Maternal-fetal medicine
• Immunology

Background:

• Fetal growth restriction (FGR) is a major cause of perinatal complications.
• Current first-trimester biomarkers for predicting FGR are limited.
• Placental dysfunction is implicated in FGR pathogenesis.

Purpose of the Study:

• To evaluate placenta-relevant molecules as biomarkers for predicting isolated FGR and its subtypes.
• To assess the predictive value of maternal serum soluble programmed death-ligand 1 (sPD-L1) in early pregnancy for FGR.

Main Methods:

• Prospective nested case-control study including singleton pregnancies.
• Maternal serum samples collected during first-trimester Down screening.
• Quantification of placenta-specific protein 1 (PLAC1), netrin-1, and sPD-L1 using ELISA kits.
• Comparison of biomarker levels between FGR cases (n=50) and controls (n=100).

Main Results:

• No significant differences in PLAC1 or netrin-1 between groups.
• Significantly lower maternal sPD-L1 levels in overall FGR and FGR subtypes compared to controls.
• sPD-L1 levels correlated positively with gestational age at delivery and birth weight Z score.
• First-trimester sPD-L1 demonstrated predictive ability for FGR, its subtypes, and NICU admission (AUCs ranging from 0.67 to 0.84).

Conclusions:

• Decreased maternal circulating sPD-L1 in early pregnancy is a potential biomarker for isolated FGR.
• sPD-L1 may aid in identifying pregnancies at risk for FGR and related adverse outcomes.
• Further validation in larger multicenter studies is warranted to confirm these findings.