Diagnostic and prognostic role of maternal serum prokineticin-1 in preeclampsia and adverse pregnancy outcomes.

Objective: Prokineticin-1 (PROK-1), known as endocrine gland-derived vascular endothelial growth factor, is an angiogenic peptide mostly produced in endocrine and placental organs. It is important for placental vascular remodeling and trophoblast control. This study sought to investigate the potential of maternal serum PROK-1 levels as a diagnostic or prognostic marker in preeclampsia (PE). Material and Methods: This prospective case-control study included women diagnosed with PE and normotensive pregnant controls. Serum samples were collected at hospital admission, and PROK-1 concentrations were quantified using a commercial ELISA kit. Clinical characteristics and perinatal outcomes were compared between groups. Receiver operating characteristic analyses were used to assess the diagnostic and prognostic performance of PROK-1 for PE, disease severity, and composite adverse perinatal outcomes (CAPO). Results: There were 45 women in the PE group and an equal number of controls. PROK-1 levels were significantly higher in PE than in controls [8.37 (10.51) vs. 4.89 (3.26) ng/mL, p<0.001). PROK-1 predicted PE with an area under the curve (AUC) of 0.721 (cut-off >5.40 ng/mL; sensitivity 75.6%, specificity 60.0%; positive predictive value 65.5%, negative predictive value 71.4%). Furthermore, severe PE cases had significantly higher PROK-1 levels than mild PE cases. PROK-1 predicted severe PE with an AUC of 0.716 (cut-off >9.80 ng/mL) and CAPO with an AUC of 0.673 (cut-off >6.53 ng/mL). Conclusion: Maternal serum PROK-1 was elevated in PE and correlated with disease severity and adverse perinatal outcomes. Although inadequate as a stand-alone marker, PROK-1 may complement existing angiogenic biomarkers in multimarker prediction models.