EARLY BIOMARKERS IN THE DIAGNOSIS OF PREECLAMPSIA

Abstract

Preeclampsia is a multisystem hypertensive illness of pregnancy and a major reason of maternal and neonatal morbidity and mortality worldwide. Because clinical manifestations often appear after significant placental dysfunction has occurred, reliable early biomarkers are essential for timely diagnosis and risk assessment. This review aims to summarize current evidence on early biomarkers for the diagnosis of preeclampsia, focusing on their biological mechanisms, diagnostic performance, clinical applications, emerging molecular technologies, and future prospects for precision medicine. The review evaluates established and emerging biomarkers, including angiogenic factors, placental proteins, inflammatory and oxidative stress markers, genetic and epigenetic biomarkers, extracellular vesicles, cell-free nucleic acids, and multi-omics approaches. Current evidence indicates that soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and the sFlt-1/PlGF ratio are among the most reliable biomarkers for early prediction. Emerging biomarkers such as microRNAs, long non-coding RNAs, circular RNAs, proteomic, metabolomic, lipidomic, and exosome-based signatures further enhance diagnostic accuracy. Integration of these biomarkers with maternal clinical characteristics, Doppler ultrasound, and artificial intelligence-based prediction models improves individualized risk assessment and clinical decision-making. Continued multicenter validation, standardized analytical methods, and accessible point-of-care technologies are essential for translating these advances into routine clinical practice and improving maternal or neonatal results.