Objectives: Evaluation of the ability of serum Pregnancy-associated Placental Protein A2 (PAPP-A2), Placental growth
factor (PLGF) and soluble fms-like tyrosine kinase 1 (sFlt-1) levels estimated at the 12th gestational weeks (GW) to predict
the possibility of development of preeclampsia (PE) in the normotensive pregnant women.
Patients: 66 PE and 66 No-PE women gave blood samples at the 12th GW for ELISA estimation of study biomarkers. During
pregnancy, 21 women had early-onset and 19 women had severe PE. Study outcome is the ability of serum cytokines' levels
estimated at the 12th GW for prediction of oncoming PE development.
Results: Blood pressure (BP) measures were significantly higher in PE women than their baseline measures and
corresponding measures of women of No-PE group. Serum levels of PAPP-A2 and sFlt-1 were significantly higher, while
levels of PLGF were significantly lower in PE than in No-PE women. ROC curve analysis defined PAPP-A2/PLGF ratio
>0.51 as discriminator point for early-onset PE with moderate accuracy (AUC=0.662; 95% CI: 0.264-0.982) and sensitivity
rate of 90.48% and negative predictive value of 94.12%.
Conclusion: Determination of PAPP-A2/PLGF ratio in serum at the 12 GW might be used as early predictor for PE and
ratio at >0.51 could predict early-onset PE with moderate accuracy.