Background: Fetal growth restriction (FGR) is a common pregnancy complication and a major contributor to increased perinatal morbidity and mortality. Our previous studies have shown that the mannose-6-phosphate receptor (M6PR) is significantly upregulated in the placenta of cases of selective FGR (sFGR). This study aimed to evaluate the M6PR levels in maternal serum during pregnancy as a novel biomarker for predicting FGR and its subtypes. Methods: From an established prospective pregnancy cohort, we selected 256 singleton pregnancies with FGR and 233 matched controls for analysis. Serum samples collected during gestation were analyzed for M6PR levels using MILLIPLEX® human cytokine magnetic bead panels. Receiver operating characteristic (ROC) analysis assessed the predictive value of M6PR. Results: The log10 multiples of the median (MoM) of M6PR were significantly lower in the FGR group than in the control group during the third trimester, with an area under the ROC curve (AUC) of 0.736. When FGR was divided into early-onset and late-onset groups in the third trimester, the log10 MoM of M6PR was significantly lower in the early-onset FGR group compared to the control group, with an AUC of 0.723. Similarly, the log10 MoM of M6PR was significantly lower in the late-onset FGR group than in the control group, with an AUC of 0.645. Conclusions: M6PR concentrations declined significantly during the third trimester, suggesting that M6PR may serve as a novel biomarker for predicting FGR. Integrating M6PR with existing biomarkers has been shown to enhance overall predictive accuracy, supporting timely clinical interventions.
Li et al. (Tue,) studied this question.