Preeclampsia: biomarkers and predictive strategies — a literature review (2015–2025)

Abstract

Background: Preeclampsia is a leading cause of maternal and neonatal morbidity and mortality world - wide. Early identification of high-risk pregnancies remains challenging, prompting the development of serum and imaging biomarkers for prediction and prevention. Objective: To summarize evidence published between 2015 and 2025 on biomarkers for prediction of preeclampsia and evaluate preventive strategies recommended by FIGO and ACOG. Methods: A narrative literature review was conducted using PubMed, Scopus, and Web of Science da - tabases. Prospective studies, meta-analyses, randomized controlled trials, and international guidelines published between 2015 and 2025 were included. Results: The soluble fms-like tyrosine kinase-1 to placental growth factor ratio (sFlt-1/PlGF) demonstrat- ed strong predictive accuracy for preeclampsia, particularly in mid-to-late gestation. Additional biomark- ers, including angiopoietins and inflammatory cytokines, improved risk stratification when combined with maternal clinical factors. Uterine artery Doppler and emerging imaging modalities enhanced detec- tion of placental dysfunction. Preventive strategies such as early low-dose aspirin initiation, risk-factor modification, and close blood pressure monitoring reduced disease incidence and adverse outcomes. Conclusion: Integration of serum and imaging biomarkers with guideline-based preventive protocols improves early prediction and management of preeclampsia. Further research is required to standardize biomarker thresholds and expand implementation in diverse clinical settings.