Maternal Serum GDF15 and Neuropilin-1 as Diagnostic Biomarkers of Third-Trimester Preeclampsia: A Case-Control Study

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Background & Objective: Cellular stress and endothelial dysfunction peak during late gestation; however, the combined diagnostic value of Growth Differentiation Factor 15 (GDF15) and Neuropilin-1 (NRP1) has not been thoroughly investigated. To evaluate the concurrent diagnostic efficacy of maternal serum GDF15 and NRP1 in identifying preeclampsia during the third trimester.Materials & Methods: This case-control study included 60 women with preeclampsia and 60 matched normotensive controls at more than 28 weeks of gestation. Serum GDF15 and NRP1 concentrations were measured using Enzyme-Linked Immunosorbent Assay (ELISA). Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis.Results: Serum GDF15 (725.2±208 vs. 523.7±112 pg/mL) and NRP1 (15.75±6.54 vs. 9.34±2.4 ng/mL) levels were significantly elevated in patients with preeclampsia compared with controls (P<0.0001). NRP1 demonstrated superior diagnostic accuracy (AUC=0.88; 76% sensitivity (95% CI: 63.2-86.0%); 87% specificity (95% CI: 75.8-94.1%)) compared with GDF15 (AUC=0.80; 70% sensitivity (95% CI: 56.8-81.2%); 79.4% specificity (95% CI: 67.3-88.5%)). A moderate positive correlation was observed between the two biomarkers (r=0.547, P<0.001). Neither marker is significantly distinguished severe from non-severe preeclampsia.Conclusion: GDF15 and NRP1 show promise as complementary biomarkers for detecting preeclampsia, reflecting distinct pathophysiological pathways related to cellular stress and angiogenic dysregulation. Although they demonstrated high diagnostic potential for identifying the presence of the disease, their utility in stratifying disease severity appears limited.