Correlation Between Placental Hormones and Placental Elasticity and the Relationship Between These Parameters and Pregnancy Outcomes

BACKGROUND: The placenta is an essential organ for regulating maternal-fetal exchange and hormonal regulation. Mechanical properties such as tissue elasticity and hormonal markers such as pregnancy-associated plasma protein A (PAPP-A) and free Beta-human chorionic gonadotropin (f-B-hCG) have been proposed as indicators of placental function, but their combined utility in predicting obstetric outcomes remains uncertain. OBJECTIVES: To evaluate the correlation between placental hormones and placental elasticity and to assess the potential utility in predicting adverse pregnancy outcomes. METHODS: In this prospective study, 134 pregnant women (16-21 weeks' gestation) underwent placental shear wave elastography (central and peripheral regions). First trimester PAPP-A and f-B-hCG results, maternal demographics, and pregnancy outcomes were collected. Obstetric complications were defined as gestational hypertension, gestational diabetes, intrauterine growth restriction, preterm birth, and low birth weight. RESULTS: Peripheral placental stiffness was significantly higher in women with complications (p = 0.043), whereas central stiffness did not differ. Maternal age and body mass index (BMI) were also higher in the complication group (p = 0.001 and p = 0.005, respectively). ROC analysis identified maternal age (76.6% sensitivity and 59.8% specificity with a cut-off value of 31), BMI (85.1% sensitivity and 37.9% specificity with a cut-off value of 23.1), and peripheral stiffness (85.1% sensitivity and 34.5% specificity with a cut-off value of 2.9 (kPa)) as moderate predictors. Analysis showed that gestational age increased the risk of complications (OR = 2.059, p < 0.001), whereas higher BMI paradoxically decreased it (OR = 0.895, p = 0.014). No significant associations were observed between PAPP-A, f-B-hCG, and adverse outcomes. CONCLUSION: Peripheral placental stiffness measured by shear wave elastography appears to be a promising noninvasive marker for predicting obstetric complications. Although hormonal biomarkers were not predictive in this cohort, larger multicenter studies are needed to evaluate the combined prognostic role of placental markers of biochemical and biomechanical.