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. 2025 Jan 27;25(1):75.
doi: 10.1186/s12884-025-07187-x.

Evaluation of placental growth factor, Vitamin D, and systemic inflammatory index as predictive biomarkers for preeclampsia severity: a retrospective cohort study

Xiaoyan Han  1 , Hua Yang  2
Affiliations

Evaluation of placental growth factor, Vitamin D, and systemic inflammatory index as predictive biomarkers for preeclampsia severity: a retrospective cohort study

Xiaoyan Han et al. BMC Pregnancy Childbirth. .

Abstract

Aim: Our study aimed to evaluate the predictive value of Placental growth factor (PlGF), Vitamin D, and systemic inflammatory index for assessing preeclampsia risk and severity.

Materials and methods: This retrospective cohort study included 457 pregnant individuals who delivered at our hospital between March 2023 and October 2024. Participants were divided into three groups: control (n = 217), mild preeclampsia (n = 101), and severe preeclampsia (n = 67). A separate validation cohort (n = 72) was used to test model performance. Data on demographic, clinical, and laboratory characteristics, including PlGF, Vitamin D, neutrophil, lymphocyte, and monocyte counts, were collected between 16 and 20 weeks of gestation. Logistic regression analysis was performed to identify independent risk factors, and receiver operating characteristic (ROC) curve analysis was used to assess the predictive power of PlGF, Vitamin D, lymphocyte count, and Pan-immune-inflammation value (PIV). The regression models adjusted for potential confounders, including maternal age, body mass index (BMI), and parity.

Results: In the training cohort, significant differences were observed among control, mild, and severe preeclampsia groups, with severe cases showing elevated PIV (515.8 ± 126.7) and reduced levels of PlGF (12.5 ± 5.8 pg/mL) and Vitamin D (8.4 ± 1.9 ng/mL) compared to controls (P < 0.001). Logistic regression identified lower levels of PlGF (P < 0.001) and Vitamin D (P < 0.001) as significant independent risk factors for severe preeclampsia. PIV was also a strong predictor, showing a high hazard ratio (P < 0.001). In the training and validation cohorts, ROC analysis showed AUC values of 0.774 and 0.751 for PlGF, 0.805 and 0.796 for Vitamin D, 0.688 and 0.675 for Lymphocyte, and 0.724 and 0.752 for PIV, respectively, indicating strong predictive value for PlGF, Vitamin D, and PIV in assessing preeclampsia risk.

Conclusion: Lower levels of PlGF and Vitamin D, along with higher PIV, were independently associated with an increased risk of severe preeclampsia. These findings suggest that PlGF, Vitamin D, and PIV are valuable biomarkers for early identification of high-risk preeclampsia patients, potentially aiding in timely intervention and improved outcomes.

Keywords: Pan-Immune Inflammation Value; Placental Growth Factor; Preeclampsia; Risk Prediction; Vitamin D.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was performed according to the Declaration of Helsinki in 1964 and its current amendments. All experiments were approved by the Ethics Committee of Capital Medical University Affiliated Beijing Friendship Hospital. Consent for publication: This study is a retrospective analysis, and all data were collected from previously recorded clinical records. The study was conducted in accordance with ethical guidelines, and approval was obtained from the the ethics committee. Due to the retrospective nature of the study, the requirement for informed consent was waived by the ethics committee. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The flowchart of our study
Fig. 2
Fig. 2
ROC Analysis for Predictive Performance of Biomarkers in Preeclampsia. A ROC curves for PLGF, Vitamin D, Lymphocyte, and PIV in the training cohort, with AUC values of 0.774, 0.805, 0.6889, and 0.724, respectively. B ROC curves for the validation cohort (n = 72) showing AUC values of 0.751 for PLGF, 0.796 for Vitamin D, 0.675 for Lymphocyte, and 0.752 for PIV
See this image and copyright information in PMC

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