Key result
Elevated maternal serum prostasin is linked to a ~20-fold higher risk of early-onset preeclampsia.
Why the study?
Pathophysiological differences and the diagnostic performance of maternal serum prostasin as a potential biomarker for early-onset preeclampsia remained to be established.
Are maternal serum prostasin levels elevated in early-onset preeclampsia compared to healthy pregnancies, and can they serve as a diagnostic biomarker?
Case-Control (n=88)
Are maternal serum prostasin levels elevated in early-onset preeclampsia compared to healthy pregnancies, and can they serve as a diagnostic biomarker?
Maternal serum prostasin levels are significantly elevated in early-onset preeclampsia and demonstrate strong diagnostic performance as a potential biomarker.
May aid early detection of early-onset PE; hypothesis-generating for prostasin as biomarker pending prospective validation.
We aimed to compare maternal serum prostasin levels between women with early-onset preeclampsia (PE) and healthy pregnant controls to establish pathophysiological differences. We also sought to evaluate the diagnostic performance of maternal serum prostasin as a potential biomarker for early-onset PE, including determination of optimal cutoff values for clinical application. This was a prospective case–control study including 43 pregnant women who were diagnosed with early-onset PE between 20 0/7 to 34 0/7 weeks of gestation from March to September 2022. Also, 45 healthy pregnant women were included in the control group. Demographic characteristics, complete blood count and biochemical parameters, and serum prostasin concentrations were documented. A receiver operating characteristic curve was generated to demonstrate the sensitivity and specificity of prostasin, and the optimal cutoff value was determined using the Youden index. The median maternal serum prostasin level was found to be significantly higher in the early-onset PE group (31.66 [27.12–51.00] ng/mL) compared to the control group (22.33 [16.03–25.89] ng/mL) with a P -value <.001. The area under the curve was found to be 0.820 ± 0.047 (95% CI: 0.729–0.912), indicating a statistically significant discriminative ability ( P < .001). The optimal cutoff value for maternal serum prostasin level was determined using the Youden index, with a threshold of ≥26.44 ng/mL corresponding to a sensitivity of 0.837 and a specificity of 0.778 for the diagnosis of early-onset PE. Based on the multivariate model results, a maternal serum prostasin value of >26.44 ng/mL increases the risk of early-onset PE by approximately 20-fold. Maternal serum prostasin levels are significantly elevated in early-onset preeclamptic mothers compared to the healthy controls. These findings suggest that prostasin may play a role in early-onset PE pathophysiology and could serve as a biomarker for its diagnosis.
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Bolluk et al. (2026) conducted a case-control in early-onset preeclampsia (n=88). Maternal serum prostasin vs. Healthy pregnant controls was evaluated on Maternal serum prostasin level (AUC 0.820, 95% CI 0.729-0.912, p=<.001). Maternal serum prostasin levels were significantly elevated in early-onset preeclampsia versus healthy controls (31.66 vs 22.33 ng/mL; P<.001), with levels >26.44 ng/mL increasing risk ~20-fold.
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