Klein Nina¹, Schulz Max², Wagner Jonas³, Krüger Mia⁴, Richter Emma⁵, Krüger Leon⁶, Schäfer Leon⁷, Neumann Sophie⁸, Schulz Emma⁹
ABSTRACT:
Preeclampsia, a hypertensive disorder of pregnancy, is characterized by placental dysfunction driven by angiogenic imbalance, hypoxia, and systemic inflammation. This review integrates current evidence on biomarkers across these pathways, including soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), hypoxia-inducible factor-1α (HIF-1α), and pro-inflammatory cytokines (IL-6, TNF-α). We evaluate their diagnostic and prognostic utility, emphasizing the sFlt-1/PlGF ratio for predicting adverse outcomes (AUC 0.92) and stratifying preterm preeclampsia. Mechanistic links between placental oxidative stress, endothelial dysfunction, and maternal symptoms are explored, alongside challenges in biomarker standardization and clinical adoption. Future directions highlight multi-modal biomarker panels, point-of-care testing, and therapeutic targeting of dysregulated pathways to improve maternal and fetal outcomes.