mvjrМедицинский вестник Юга РоссииMedical Herald of the South of Russia2219-80752618-7876The Rostov State Medical University10.21886/2219-8075-2026-17-2-31-41mvjr-2212Research ArticleАКУШЕРСТВО И ГИНЕКОЛОГИЯOBSTETRICS AND GYNECOLOGYРоль ангиогенных и антиангиогенных факторов в стратификации риска преэклампсии у беременных групп высокого и низкого риска по результатам расширенного пренатального скринингаThe role of angiogenic and antiangiogenic factors in the stratification of preeclampsia risk in high- and low-risk pregnant women according to the results of extended prenatal screeninghttps://orcid.org/0000-0002-0342-8745КузнецоваН. Б.KuznetsovaN. B.

Кузнецова Наталья Борисовна, д.м.н., профессор, профессор центра симуляционного обучения

Ростов-на-Дону

Natalia B. Kuznetsova, Dr. Sci. (Med.), Professor, Professor, Center for Simulation Training

Rostov-on-Don

lauranb@inbox.ruhttps://orcid.org/0000-0001-8102-2460ШаталовА. Е.ShatalovA. E.

Шаталов Александр Евгеньевич, аспирант кафедры акушерства и гинекологии №3

Ростов-на-Дону

Alexander E. Shatalov, Postgraduate Student of the Department of Obstetrics and Gynecology No.3

Rostov-on-Don

shatal321@mail.ruhttps://orcid.org/0000-0002-8584-7096БариноваВ. В.BarinovaV. V.

Баринова Виктория Владиславовна, к.м.н., врач акушер-гинеколог

Ростов-на-Дону

Victoria V. Barinova, Cand. Sci. (Med.), Obstetrician-gynecologist, Professor 

Rostov-on-Don

victoria-barinova@yandex.ruhttps://orcid.org/0009-0002-4527-8949БулкаковаО. Ш.BulkakovaO. Sh.

Булкакова Оксана Шахбановна, врач ультразвуковой диагностики

Ростов-на-Дону

Oksana Sh. Bulkakova, Ultrasound Diagnostics Doctor, Professor

Rostov-on-Don

oksana.bulkakova@mail.ruРостовский государственный медицинский университетРоссияRostov State Medical UniversityRussian FederationКлиника профессора БуштыревойРоссияBustyreva Clinic LLCRussian Federation2026220620261723141Copyright © Кузнецова Н.Б., Шаталов А.Е., Баринова В.В., Булкакова О.Ш., 20262026Кузнецова Н.Б., Шаталов А.Е., Баринова В.В., Булкакова О.Ш.Kuznetsova N.B., Shatalov A.E., Barinova V.V., Bulkakova O.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medicalherald.ru/jour/article/view/2212Цель

Цель: оценить эффективность использования РАРР-А и PlGF в I триместре беременности и скорость нарастания ангиогенного дисбаланса (sFLT-1/PLGF) во II–III триместрах для ранней и точной стратификации беременных высокого риска по развитию преэклампсии.

Материалы и методы

Материалы и методы: в проспективное исследование включены 69 беременных женщин, разделённых на две группы: I группу (с высоким риском преэклампсии, n=37), и II группу (с низким риском преэклампсии, n=32). Определение уровней биомаркеров ангиогенеза PlGF и sFlt-1 проводилось в динамике, в сроках беременности 20, 24, 28, 32 недель.

Результаты

Результаты: у I группы в 12 недель уровни РАРР-А (1,55±2,0 мЕ/л) и PlGF (27,34±25,80 мЕ/л) были ниже по сравнению с женщинами из II группы, РАРР-А (3,23±2,34 мЕ/л, p<0,001) и PlGF (43,21±14,58 мЕ/л, p=0,012), соответственно.  Исследование sFlt-1/PlGF показало повышение у I группы в 24 недели (31,2±49 мЕ/л) по сравнению со II группой (3,7±1,8 мЕ/л) (p=0,002). Концентрация sFlt-1 в группе высокого риска повышалась с 20-ой по 32-ую недели, достигая 6369,4±5078 пг/мл (p=0,030). Преэклампсия развилась у 45,9% женщин I группы в отличие от 15,6% женщин II группы (p=0,003), отношение шансов — 0,217 (95% ДИ: 0,077–0,609).

Заключение

Заключение: оценка уровня РАРР-А и PlGF в I триместре и динамики sFlt-1/PlGF в сроках 20, 24, 28, 32 недель позволяет осуществлять стратификацию риска преэклампсии у беременных высокого риска по преэклампсии. Выявленная динамика ангиогенного дисбаланса (значимые различия получили с 24-ой недели) опережает клиническую манифестацию на 8–12 недель.

Оbjective

Оbjective: to evaluate the effectiveness of using MAPP-A and PlGF in the first trimester of pregnancy and the rate of increase in angiogenic imbalance (sFlt-1/PLGF) in the second to third trimesters for early and accurate stratification of highrisk pregnant women for the development of preeclampsia.

Materials and methods

Materials and methods: the prospective study included 69 pregnant women divided into two groups: group 1, with a high risk of preeclampsia, n=37, and group 2, with a low risk of preeclampsia, n=32. The levels of angiogenesis biomarkers: PlGF and sFlt-1 were determined in dynamics, at gestation periods of 20, 24, 28, 32 weeks.

Results

Results: in group 1, at 12 weeks, the levels of RARP-A (1.55 ± 2.0 iU/l) and PlGF (27.34 ± 25.80 iU/l) were lower than in women from group 2, RARP-A (3.23 ± 2.34 iU/L, p<0.001) and PlGF (43.21 ± 14.58 iU/l, p=0.012), respectively.  The sFlt-1/PlGF study showed an increase in the 1st group at 24 weeks - 31.2 ± 49 iU/l compared with the 2nd group - 3.7 ± 1.8 iU/l (p=0.002). The concentration of sFlt-1 in the high-risk group increased from the 20th to the 32nd week, reaching 6369.4 ± 5078 pg/ml (p=0.030). Preeclampsia developed in 45.9% of women in group 1, as opposed to 15.6% of women in group 2 (p=0.003), odds ratio 0.217 (95% CI: 0.077–0.609).

Conclusion

Conclusion: assessment of the level of PAPP-A and PlGF in the first trimester and the dynamics of sFlt-1/PlGF at 20, 24, 28, and 32 weeks allows stratification of the risk of preeclampsia in high-risk pregnant women by preeclampsia. The revealed dynamics of angiogenic imbalance, significant differences were obtained from the 24th week, is 8-12 weeks ahead of the clinical manifestation.

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The authors declare that there are no conflicts of interest present.