Diminished pleiotrophin as a new clue to pre-eclampsia: Linking impaired angiogenesis to adverse outcomes.

objectiveTo evaluate maternal serum pleiotrophin (PTN) levels in pregnancies complicated by pre-eclampsia (PE) and to determine their association with disease severity and adverse perinatal outcomes.

methodsThis prospective case-control study included 45 women diagnosed with mild or severe PE and 45 gestational-age-matched healthy pregnant controls. Maternal serum PTN levels were measured using enzyme-linked immunosorbent assay. Demographic, obstetric and neonatal outcomes were compared between groups. Receiver operating characteristic (ROC) analyses were performed to assess the predictive value of PTN for PE, severe PE, and composite adverse perinatal outcomes (CAPO).

resultsMedian serum PTN levels were significantly lower in women with PE than in healthy controls (14.47 vs. 30.92 ng/mL; P < 0.001). PTN concentrations were also reduced in severe compared with mild PE (13.43 vs. 29.77 ng/mL; P = 0.019). ROC analysis identified PTN cutoff values of 23.73 ng/mL for PE diagnosis (AUC = 0.703), 20.40 ng/mL for severe PE (AUC = 0.656), and 18.67 ng/mL for CAPO prediction (AUC = 0.667). The PE group had significantly higher rates of preterm birth, fetal growth restriction, neonatal intensive care unit admission, and CAPO.

conclusionDecreased maternal serum PTN levels are associated with the presence and severity of pre-eclampsia, as well as adverse perinatal outcomes. PTN may serve as an additional angiogenic-related biomarker that complements existing diagnostic tools and improves risk stratification in pregnancies complicated by PE.