Placental Growth Factor as a Predictor of Early Preeclampsia in Sickle Cell Disease
New research indicates that measuring placental growth factor (PlGF) levels during pregnancy can accurately predict early-onset preeclampsia in individuals with sickle cell disease (SCD).The study, conducted by researchers from Mount Sinai Hospital, Canada, and collaborators, builds on the established role of PlGF as a preeclampsia risk marker in the general population.
PlGF levels naturally increase as the placenta develops throughout pregnancy, peaking near term. While low PlGF is a strong indicator of preterm preeclampsia in pregnancies without SCD, its interpretation has been challenging in SCD patients due to their typically higher baseline PlGF levels, even when not pregnant. This prompted researchers to investigate PlGF’s diagnostic value specifically for SCD pregnancies, a critical need given the doubled risk of placental complications and preeclampsia faced by these patients.
The retrospective study, analyzing data from 2017 to 2021, involved collecting mid-trimester PlGF levels from pregnant individuals with SCD and a control group of Black individuals without SCD. Researchers then correlated these levels with pregnancy outcomes.The results revealed that a PlGF cut-off of below 100 picograms per millilitre, measured between 20 and 24 weeks’ gestation, demonstrated 100% sensitivity and specificity in predicting early-onset preeclampsia within the SCD cohort.This performance surpasses that of existing thresholds used for preeclampsia prediction in pregnancies not intricate by SCD.
However, the study also found that this threshold’s accuracy diminished when predicting late-onset preeclampsia, requiring substantially higher cut-offs. This suggests differing underlying mechanisms contribute to early versus late preeclampsia in SCD pregnancies.
These findings establish low PlGF as a valuable early warning signal for preeclampsia in SCD pregnancies, potentially enabling clinicians to proactively manage complications and improve maternal and fetal outcomes. The research also identified a correlation between low PlGF levels and placental vascular disease in SCD, reinforcing its utility as a marker of placental health.
Researchers emphasize the need for validation of these findings in larger, multicenter trials.they also suggest integrating PlGF measurements with other biomarkers to further refine preeclampsia prediction for vulnerable pregnancies. this advancement holds the potential to significantly improve pregnancy monitoring for individuals with SCD.
Reference:
Vlachodimitropoulou E et al. Utility of placental growth factor (plgf) for preeclampsia prediction in pregnancies complicated by sickle cell disease. Blood Adv. 2025:bloodadvances.2025016821.
