Abstract

Objectives: Evaluation of the ability of serum Pregnancy-associated Placental Protein A2 (PAPP-A2), Placental growth factor (PLGF) and soluble fms-like tyrosine kinase 1 (sFlt-1) levels estimated at the 12th gestational weeks (GW) to predict the possibility of development of preeclampsia (PE) in the normotensive pregnant women.

Patients: 66 PE and 66 No-PE women gave blood samples at the 12th GW for ELISA estimation of study biomarkers. During pregnancy, 21 women had early-onset and 19 women had severe PE. Study outcome is the ability of serum cytokines' levels estimated at the 12th GW for prediction of oncoming PE development.

Results: Blood pressure (BP) measures were significantly higher in PE women than their baseline measures and corresponding measures of women of No-PE group. Serum levels of PAPP-A2 and sFlt-1 were significantly higher, while levels of PLGF were significantly lower in PE than in No-PE women. ROC curve analysis defined PAPP-A2/PLGF ratio >0.51 as discriminator point for early-onset PE with moderate accuracy (AUC=0.662; 95% CI: 0.264-0.982) and sensitivity rate of 90.48% and negative predictive value of 94.12%.

Conclusion: Determination of PAPP-A2/PLGF ratio in serum at the 12 GW might be used as early predictor for PE and ratio at >0.51 could predict early-onset PE with moderate accuracy.

Keywords: Preeclampsia, Early-onset, Pregnancy-associated placental protein A2, Placental growth factor, Soluble fms-Like Tyrosine Kinase-1, Early predictors