Biochemical markers in predicting adverse pregnancy outcomes and placental dysfunction: A literature review
Makhambetova K.Sh. Komlichenko E.V. Kamyshanskiy E.K. Ponamareva O.A. Amirbekova Z.T. Oshakhtieva N.M.
1 April 2025Kaz Med Print LLP
Reproductive Medicine (Central Asia)
2025#2025Issue 141 - 48 pp.
Relevance: Adverse pregnancy outcomes, including preeclampsia, gestational hypertension, fetal growth restriction (FGR), and other placental-mediated complications, remain one of the leading causes of maternal and perinatal mortality. In recent years, the role of biochemical markers as tools for the early detection of pregnancy pathologies has been actively studied. However, despite many studies, the use of biochemical markers in clinical practice remains limited due to insufficient standardization, heterogeneity of data, and variability in predictive accuracy. The study aimed to study the significance of various biochemical markers for predicting adverse pregnancy outcomes and placental dysfunction. Materials and Methods: To conduct a literature review, published scientific studies in English and Russian on biochemical markers used to predict adverse pregnancy outcomes and placental dysfunction were analyzed. The literature search was carried out in the Web of Science, PubMed, Cochrane Library, and Scopus databases, and sources of domestic literature for the period from 2014 to 2024 were analyzed. Results: The study of biochemical markers allows us to identify placental dysfunction and predict pregnancy complications, such as preeclampsia, gestational hypertension, and FGR. PAPP-A and PlGF are of greatest clinical importance, the decrease of which in the first trimester is associated with a high risk of placental disorders. The sFlt-1/PlGF ratio demonstrates high prognostic value in preeclampsia, especially when combined with uterine artery Doppler. Inflammatory markers can reflect endothelial dysfunction, but their clinical use is limited by high variability in values. The main challenges remain the standardization of biomarker thresholds and the universalization of their use. Conclusion: Prediction of adverse pregnancy outcomes and placental dysfunction remains challenging due to the lack of standardized cutoff values and heterogeneity of risk factors. A combined approach including angiogenic and inflammatory markers improves the accuracy of preeclampsia prediction. This review provides up-to-date data on biochemical markers to help optimize the management of patients at high risk of placental dysfunction.
adverse pregnancy outcomes , biochemical markers , fetal growth restriction , placental dysfunction , preeclampsia , small for gestational age fetus
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Karaganda Medical University, Karaganda, Kazakhstan
Institute of Perinatology and Pediatrics of the Almazov National Medical Research Center, St. Petersburg, Russian Federation
Karaganda Medical University
Institute of Perinatology and Pediatrics of the Almazov National Medical Research Center
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