Diagnostic Efficacy of a Multi-Biomarker Panel Comprising Angiogenic, Metabolic, and Endocrine Markers for Preeclampsia Detection and Severity Stratification in an Iraqi Cohort

Background & Objective: Preeclampsia (PE) causes an important proportion of maternal and neonatal morbidity and mortality globally, especially in countries lacking resources where diagnostic capabilities are minimal. However, full multi-marker panels reflecting angiogenic and metabolic pathways have not been assessed in Middle Eastern populations, which are in dire need of population-specific data. This study was conducted with aim to estimate the diagnostic utility of leptin, Vascular Endothelial Growth Factor (VEGF), soluble Fms-Like Tyrosine kinase-۱ (sFlt-۱), Estradiol (E۲), and Placental Growth Factor (PlGF) in maternal serum for detection in the early stage of PE and its severity. Materials & Methods: This case-control study was performed in the inpatients section of the Babylon Teaching Hospital, Iraq. A total of ۱۲۰ third-trimester pregnant women (۶۰ preeclamptic and ۶۰ normotensive controls) were included. The preeclamptic women included mild (n=۳۲) and severe (n=۲۸) cases. Sera biomarkers were detected by ELISA and predictive value was estimated by ROC and binary logistic regression. Data were analyzed using the Graph Pad Prism (version ۹). P<۰.۰۵ was considered significant. Results: All five biomarkers were significantly deregulated in PE (P<۰.۰۰۱). VEGF and PlGF were markedly suppressed, and leptin, sFlt-۱, and estradiol levels increased with severity. The combined model yielded ۱۰۰% accuracy for both diagnosis and severity stratification. PlGF exhibited perfect discrimination for severity (AUC=۱.۰۰۰); sFlt-۱ (OR=۲.۸۰) and leptin (OR=۱. (۸۰) were significant independent risk factors for severe progression. Conclusion: The integration of angiogenic markers with metabolic and endocrine markers provides a robust framework that enhances diagnostic precision and severity stratification, offering translational potential for risk-directed surveillance in resource-limited obstetric settings.

کلیدواژه ها:

Pregnancy-induced Hypertension ، Angiogenesis Modulating Agents ، Adipokines ، Estrogens