Predictive Biomarkers in Preeclampsia Assessment
Summary
Preeclampsia remains a leading cause of maternal and perinatal morbidity worldwide. Its clinical presentation typically emerges in the second half of pregnancy but has roots in early abnormal placentation and endothelial dysfunction. Central to current research is the imbalance between pro-angiogenic and anti-angiogenic factors released by the placenta. In particular, reduced levels of placental growth factor (PlGF) and elevated soluble fms-like tyrosine kinase-1 (sFlt-1) precede the onset of hypertension, proteinuria and organ dysfunction. Quantification of these biomarkers—often expressed as an sFlt-1/PlGF ratio—has been shown to accelerate diagnosis, discriminate preeclampsia from other hypertensive disorders and guide clinical management. Automated immunoassays have facilitated adoption into routine care in high-income settings, enabling rule-out testing with high negative predictive value. However, optimal use of repeat measurements, integration with maternal risk factors and expansion into low-resource environments remain challenges. Emerging technologies, including point-of-care biosensors and machine-learning algorithms, promise further advances in sensitivity, rapidity and global accessibility.
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Predictive Biomarkers in Preeclampsia Assessment publication trend
The graph below shows the total number of articles in predictive biomarkers in preeclampsia assessment across all publications each year (not limited to Nature Index journals).
Technical terms
Angiogenic biomarker: A molecule reflecting formation or inhibition of blood vessels associated with placental health.
Placental growth factor (PlGF): A pro-angiogenic protein secreted by the placenta; levels fall before clinical preeclampsia.
Soluble fms-like tyrosine kinase-1 (sFlt-1): An anti-angiogenic splice variant that binds and neutralises PlGF; levels rise in preeclampsia.
sFlt-1/PlGF ratio: The quotient of circulating sFlt-1 to PlGF concentrations; used to predict, rule in or rule out preeclampsia.
Localised surface plasmon resonance (LSPR): An optical phenomenon in nanoscale metals exploited to detect molecular binding events through shifts in light absorption.
References
- Repeat placental growth factor-based testing in women with suspected preterm pre-eclampsia (PARROT-2): a multicentre, parallel-group, superiority, randomised controlled trial. The Lancet (2024).
- PREPARE: A Stepped-Wedge Cluster-Randomized Trial to Evaluate Whether Risk Stratification Can Reduce Preterm Deliveries Among Patients With Suspected or Confirmed Preterm Preeclampsia. Hypertension (2023).
- Bowtie Nanoantenna LSPR Biosensor for Early Prediction of Preeclampsia. Biosensors (2024).
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