Biochemical markers in predicting adverse pregnancy outcomes and placental dysfunction: A literature review
DOI:
https://doi.org/10.37800/RM.1.2025.442Keywords:
biochemical markers, adverse pregnancy outcomes, placental dysfunction, preeclampsia, fetal growth restriction, small for gestational age fetusAbstract
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.
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