Skip to main content
NUTRITION 2025 Main banner

Maternal, Perinatal and Pediatric Nutrition (Poster Session)

(P27-020-25) Association of Plasma Biomarkers With Risk of Preeclampsia in India

Monday, June 2, 2025
12:45 PM - 1:45 PM ET
Location: Poster Board A-20
Disclosure(s):
Pratibha Dwarkanath, M.Sc, Ph.D: No relevant financial relationship(s) with ineligible companies to disclose.
Nandita Perumal, PhD, MPH: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: Hypertensive disorders of pregnancy (HDP), including preeclampsia (PE), affect 2-8% of pregnancies. Calcium supplementation reduces the risk of HDP through its hypothesized role in blood pressure regulation affecting peripheral vascular resistance and angiogenesis. We evaluated the association of plasma biomarkers at baseline ( < 20 weeks of gestation) and 32 weeks with PE incidence in Indian pregnant women.

Methods: We conducted a nested case-cohort study within a randomized, double-blind, non-inferiority trial that compared the efficacy of 500 mg/d with 1500 mg/d calcium supplementation for PE prevention in nulliparous women in India. The trial demonstrated that low-dose calcium was non-inferior to high-dose in reducing PE prevalence. This analysis included randomly selected cohort (n=1541) and all PE cases (n=105) from the eligible 2853 participants. Blood samples collected at baseline and 32 weeks of gestation were analyzed for angiogenic ((soluble fms-like tyrosine kinase receptors [sFlt1], placental growth factor [PlGF], soluble endoglin [sEng]), metabolic (leptin, renin), inflammatory (C-reactive protein [CRP], soluble tumor necrosis factor receptor 2 [sTNFR2], Interferon- gamma [IFN-γ], interleukin 6 [IL-6]), and endocrine biomarkers (parathyroid hormone [PTH]) using Luminex MAGPIX multiplex assays, immunoturbidimetric or electrochemiluminescence immunoassays. Hazard ratios (HR) and 95% confidence intervals for risk of PE were estimated using weighted Cox regression models to evaluate the association between biomarker quartiles (Q1 as the reference).

Results: High levels of sFlt-1/PlGF ratio, IL-6 and leptin concentrations at baseline (Q4:HR=0.57, p=0.040; HR=2.89; p=0.017; HR=2.75, p=0.012) and at 32 weeks (Q4:HR=6.71, p< 0.001; HR=2.65, p=0.004; HR=4.14, p< 0.001) were associated with risk of PE. The Q4 values of PIGF at 32 weeks (Q4:HR=0.07; p< 0.001) showed a protective effect on PE risk. The high concentrations of sFlt-1, sEng, sTNFR2 and PTH (Q4:HR=4.63, p< 0.001; HR=13.21; p< 0.001; Q4:HR=2.52, p=0.006; HR=2.49, p=0.017) at 32 weeks showed an increased risk of PE.

Conclusions: Plasma angiogenic and inflammatory biomarkers are associated with risk of PE, suggesting their potential use for early detection, prevention and management of PE.

Funding Sources: Bill & Melinda Gates Foundation