ArticleInternational journal of women's health2026
Evaluating Maternal Serum SHH Levels in the First Trimester as a Potential Biomarker for Predicting Preeclampsia.
Article in International journal of women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- First-trimester multi-modal cell-free DNA analysis for prediction of preterm and term preeclampsia.AJOG global reports · 2026Article
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Objective: To determine whether first-trimester maternal serum Sonic Hedgehog (SHH) predicts subsequent preeclampsia and to compare its predictive performance with soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF). Materials and Methods: In a prospective cohort study, women with singleton pregnancies were enrolled at 8-13 weeks' gestation, clinical data were recorded, and fasting serum was collected. SHH, sFlt-1, and PlGF were quantified by ELISA in triplicate with coefficients of variation <10%. Associations between SHH and subsequent preeclampsia were tested using multivariable logistic regression with adjusted confounders; discriminative ability was evaluated by ROC analysis and stratified for early-onset (≤34 weeks) and late-onset (>34 weeks) preeclampsia. Results: Among 2532 enrolled pregnancies, 271 developed preeclampsia and 2261 remained normotensive. First-trimester SHH concentrations were significantly lower in pregnancies that later developed preeclampsia, with the greatest decrement in early-onset disease. Compared to the highest SHH tertile, adjusted odds of preeclampsia were higher in the middle (OR 2.64; 95% CI 1.334-5.38) and lowest tertiles (OR 5.21; 95% CI 3.15-8.42). SHH achieved an AUC of 0.86 (95% CI 0.62-0.91), with 81.46% sensitivity and 76.58% specificity at 58.26 ng/mL; sFlt-1 and PlGF yielded AUCs of 0.71 and 0.62, respectively. Performance was strongest for early-onset preeclampsia with an AUC of 0.93 (95% CI 0.67-0.97); sensitivity 87.73%; specificity 82.43% at 62.37 ng/mL, and modest for late-onset preeclampsia with an AUC of 0.75 (95% CI 0.54-0.86); sensitivity 73.42%; specificity 68.24% at 55.78 ng/mL. Conclusion: Lower maternal serum SHH level in the first trimester is independently associated with later development of preeclampsia and provides clinically significant early prediction, particularly for early-onset disease. Incorporating SHH into first-trimester multiparametric screening alongside maternal factors and angiogenic markers may improve risk stratification and enable earlier prophylaxis and individualized antenatal surveillance.
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