Angiogenic proteins and adipocytokines as markers for prediction of preeclampsia

Preeclampsia is characterized by the onset of high blood pressure and proteinuria in pregnancy, leading to substantial maternal and neonatal morbidity and mortality. It involves abnormal remodeling of the placental bed vasculature, placental ischemia and endothelial cell dysfunction. Defective placental development might reflect alterations in the levels of various biological markers. Affected patients show remarkable imbalances of angiogenic factors, including PlGF, soluble FMS-like tyrosine kinase 1, soluble endoglin and angiopoietin-2; these factors could therefore be potential markers for predicting preeclampsia with or without uterine artery Doppler ultrasonography. However, use of these markers to predict preeclampsia has yet to achieve the positive and negative likelihood ratios necessary if they are to be used in clinical practice. Large-scale studies using known markers are likely to identify suitable candidates that will enable greatly improved perinatal care, including prevention and better outcomes for patients with preeclampsia.