Dynamic study of pre-eclampsia markers in the second half of pregnancy in high-risk patients
Authors:   D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, Saint Petersburg, Russian Federation, Kapustin R.V. , Chepanov S.V. ,   D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, Saint Petersburg, Russian Federation, Prokhorova V.S. ,   D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, Saint Petersburg, Russian Federation, Shelaeva E.V. ,   D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, Saint Petersburg, Russian Federation, Alekseenkova E.N. ,   D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, Saint Petersburg, Russian Federation, Kopteeva E.V. ,   D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, Saint Petersburg, Russian Federation, Arzhanova O.N. ,   D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, Saint Petersburg, Russian Federation, Kogan I.Yu. ,   D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, Saint Petersburg, Russian Federation
Published: January 2025

Objective. To determine the blood levels and correlation of pre-eclampsia (PE) markers (sFlt-1, PlGF) at 20–22 and 30–32 weeks’ gestation in women who are at high risk for developing adverse obstetrical outcomes and to study the patterns between them and clinical characteristics of pregnancy.
Patients and methods. This longitudinal prospective cohort study included 113 pregnant women who were examined and gave birth between 2020 and 2022. All patients were divided into several groups: group I (n = 34) – pre-gestational diabetes mellitus (DM); group II (n = 21) – chronic arterial hypertension (CAH); group III (n = 25) – obesity; group IV (n = 8) – women aged ≥40 years after the use of assisted reproductive technologies (ART); group V (n = 25) – control group. The levels of sFlt‑1, PlGF and their ratio at 20–22 and 30–32 weeks’ gestation were determined, considering the presence of PE and/or fetal growth restriction (IUGR). The correlation between their levels and the development of PE and IUGR, as well as the risk of PE, was evaluated according to the combined first-trimester screening.
Results. The sFlt-1/PlGF ratio was higher in groups I, II and IV at 20–22 and 30–32 weeks’ gestation. The highest value of sFlt‑1/PlGF ratio was observed in patients with gestational arterial hypertension (GAH) and PE, especially with its severe form. In all patients who had moderate PE, the sFlt-1/PlGF ratio was above 38, and in severe PE it was above 85. There was a direct correlation between the sFlt-1/PlGF ratio and the risk of developing PE (0.585; 0.526), an inverse correlation with the PE risk quartile (-0.606; -0.579) and time to PE manifestation in the groups of patients with DM (-0.277; -0.164) and CAH (-0.383; -0.581), and a direct correlation with uterine artery pulsatility index (UtA-PI) at the time of the study (0.459; 0.588).
Conclusion. This study emphasizes the importance of dynamic monitoring of PE markers in the blood of high-risk pregnant women for timely initiation of necessary clinical interventions.