电邮这篇文章 Molecular markers of the second wave of trophoblast invasion as predictors of chronic placental insufficiency
- 作者: Eremeeva D.R.1,2,3, Zainulina M.S.1,2,3
-
隶属关系:
- Academician I.P. Pavlov First St. Petersburg State Medical University
- Saint Petersburg Medical and Social Institute
- Snegirev Maternity Hospital No. 6
- 期: 卷 74, 编号 5 (2025)
- 页面: 14-22
- 栏目: Original study articles
- URL: https://bakhtiniada.ru/jowd/article/view/363328
- DOI: https://doi.org/10.17816/JOWD689531
- EDN: https://elibrary.ru/WEIEGC
- ID: 363328
如何引用文章
开放存取
##reader.subscriptionAccessGranted##
订阅存取
详细
BACKGROUND: Chronic placental insufficiency is a key factor of perinatal morbidity and mortality. This condition is caused by a disruption of the second wave of trophoblast invasion, accompanied by a deficiency in angiogenesis and activation of the hemostatic system. Currently, the possibility of early detection of women with a high risk of developing chronic placental insufficiency before clinical manifestations occur is of particular interest.
AIM: The aim of this study was to develop and validate a mathematical model at the stage of the second wave of trophoblast invasion (16–18 weeks of pregnancy) based on the assessment of immunological, angiogenic and coagulological markers for predicting the high risk of developing chronic placental insufficiency in women.
METHODS: This cross-sectional single-center study included pregnant women with complicated obstetric history. The levels of D-dimer, antithrombin III, soluble fms-like tyrosine kinase-1 activity / placental growth factor ratio, and antibodies to phospholipids were assessed in the study groups. The logistic regression method was used to build a prognostic model. Model performance was assessed by sensitivity, specificity, and area under the ROC curve.
RESULTS: This study enrolled 462 pregnant women. With a probability threshold of ≥0.332, the model demonstrated a sensitivity of 87.5%, a specificity of 75.0%, and AUC of 0.838 (p < 0.05). A relationship was found between the angiogenesis and coagulation profile parameters.
CONCLUSION: The developed mathematical model allows for highly accurate prediction of the risk of developing chronic placental insufficiency in the second wave of trophoblast invasion. Its use in clinical practice may contribute to early detection of high-risk patients and timely initiation of preventive therapy aimed at improving placental perfusion and reducing perinatal complications.
作者简介
Dina Eremeeva
Academician I.P. Pavlov First St. Petersburg State Medical University; Saint Petersburg Medical and Social Institute; Snegirev Maternity Hospital No. 6
Email: dina-bikmullina@yandex.ru
ORCID iD: 0000-0003-4512-9599
SPIN 代码: 8272-0950
Scopus 作者 ID: 57201320518
MD. Cand. Sci. (Medicine)
俄罗斯联邦, Saint Petersburg; Saint Petersburg; Saint PetersburgMarina Zainulina
Academician I.P. Pavlov First St. Petersburg State Medical University; Saint Petersburg Medical and Social Institute; Snegirev Maternity Hospital No. 6
编辑信件的主要联系方式.
Email: zainulina@yandex.ru
ORCID iD: 0000-0002-2622-5000
SPIN 代码: 3955-8429
MD, Dr. Sci. (Medicine), Professor
俄罗斯联邦, Saint Petersburg; Saint Petersburg; Saint Petersburg参考
- Chen T, Baldauf CE, Gill KS, et al. Soluble Fms-like tyrosine kinase-1 polymorphisms associated with severe-spectrum hypertensive disorders of pregnancy. Arch Gynecol Obstet. 2025;311(3):609–619. doi: 10.1007/s00404-024-07917-0 EDN: GRKMNC
- Chau K, Hennessy A, Makris A. Placental growth factor and pre-eclampsia. J Hum Hypertens. 2017;31(12):782–786. doi: 10.1038/jhh.2017.61
- Karumanchi SA. Angiogenic factors in preeclampsia: from diagnosis to therapy. Hypertension. 2016;67(6):1072–1079. doi: 10.1161/HYPERTENSIONAHA.116.06421
- Phipps EA, Thadhani R, Benzing T, et al. Pre-eclampsia: pathogenesis, novel diagnostics and therapies. Nat Rev Nephrol. 2019;15(5):275–289. doi: 10.1038/s41581-019-0119-6 EDN: EWYGWF
- Kobayashi T, Terao T. Preeclampsia as chronic disseminated intravascular coagulation. Study of two parameters: thrombin-antithrombin III complex and D-dimers. Gynecol Obstet Invest. 1987;24(3):170–178. doi: 10.1159/000298799
- He S, Bremme K, Blombäck M. Fibrin d-dimer levels in preeclamptic pregnancies with birth of small-for-gestational-age neonates. Hypertension in Pregnancy. 1998;17(2):217–226. doi: 10.3109/10641959809006077
- Fanget C, Chauleur C, Stadler A, et al. Relationship between plasma D-dimer concentration and three-dimensional ultrasound placental volume in women at risk for placental vascular diseases: a monocentric prospective study. PLoS One. 2016;11(6):e0156593. doi: 10.1371/journal.pone.0156593
- Obeagu EI, Obeagu GU. Maternal hypoxia and placental dysfunction: insights from molecular biology. Elite Journal of Health Science. 2024;2(8):58–69.
- Hadlock FP, Harrist RB, Sharman RS, et al. Estimation of fetal weight with the use of head, body, and femur measurements-a prospective study. Am J Obstet Gynecol. 1985;151(3):333–337. doi: 10.1016/0002-9378(85)90298-4
- Gordijn SJ, Beune IM, Thilaganathan B, et al. Consensus definition of fetal growth restriction: a Delphi procedure. Ultrasound Obstet Gynecol. 2016;48(3):333–339. doi: 10.1002/uog.15884
- Pavlova NG, Zajnulina MS, Arzhanova ON, et al. Placental insufficiency. Saint Petersburg: N–L; 2007. (In Russ.)
- Redman CW, Sargent IL. Placental stress and pre-eclampsia: a revised view. Placenta. 2009;30(Suppl A):S38–S42. doi: 10.1016/j.placenta.2008.11.021
- Maynard SE, Karumanchi SA. Angiogenic factors and preeclampsia. Semin Nephrol. 2011;31(1):33–46. doi: 10.1016/j.semnephrol.2010.10.004
- Levine RJ, Maynard SE, Qian C, et al. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med. 2004;350(7):672–683. doi: 10.1056/NEJMoa031884 EDN: GRAAHJ
- Rocha B, Ruiz-Romero C, Blanco FJ. Mass spectrometry imaging: a novel technology in rheumatology. Nat Rev Rheumatol. 2017;13(1):52–63. doi: 10.1038/nrrheum.2016.184
- Makatsariya AD, Bitsadze VO, Hizroeva DH, et al. Pathogenetic significance of antiphospholipid antibodies. Practical medicine. 2012;(5):9–21. EDN: PCNWVL
补充文件
