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Objective <p>To compare maternal serum thrombospondin-4 (TSP-4) levels in pregnancies with late-onset fetal growth restriction (LO-FGR) versus healthy controls and to assess their correlation with Doppler ultrasound parameters and neonatal outcomes.</p> Materials and Methods <p>This case–control study was conducted&#xa0;at Ankara Etlik City Hospital and included 47 pregnant women with LO-FGR between 32 and 37&#xa0;weeks of gestation and 43 age and gestational week-matched controls. Maternal serum TSP-4 concentrations were quantified using ELISA. Fetal biometric data, Doppler parameters, and neonatal outcomes were documented. The diagnostic effectiveness of TSP-4 levels in forecasting LO-FGR was assessed by ROC analysis. Furthermore, LO-FGR cases were divided based on composite adverse perinatal outcomes (CAPO) and compared in terms of clinical, sonographic, and TSP-4 levels.</p> Results <p>Maternal TSP-4 levels were markedly reduced in the LO-FGR group (p = 0.011). TSP-4 negatively correlated with LO-FGR (r = –0.269) and positively correlated with gestational age (r = 0.267), abdominal circumference (r = 0.257), and estimated fetal weight (r = 0.290). ROC analysis revealed moderate diagnostic accuracy for TSP-4 in predicting LO-FGR (AUC = 0.661; 95% CI 0.552–0.759; p = 0.007), whereas the cerebroplacental ratio (CPR) showed the highest accuracy (AUC = 0.782; 95% CI 0.683–0.862; p &lt; 0.001). TSP-4 levels did not significantly differ between LO-FGR cases with and without CAPO (p = 0.494).</p> Conclusion <p>Maternal serum TSP-4 levels were lower in LO-FGR cases and correlated favorably with fetal biometric measures. ROC analysis indicated that TSP-4 exhibited moderate selective capability in diagnosing LO-FGR; however, it showed no association with CAPO. TSP-4 may be a supplementary biomarker that enhances diagnostic precision when assessed with Doppler data.</p>

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Investigation of Maternal Serum Thrombospondin-4 Levels in Late-Onset Fetal Growth Restriction

  • 期刊论文

  • 发表日期：

    2025年9月6日

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  • Ayşe Yiğit,
  • Recep Taha Ağaoğlu,
  • Edanur Yilmaz,
  • Özgür Volkan Akbulut,
  • Zehra Vural Yilmaz

摘要

Objective

To compare maternal serum thrombospondin-4 (TSP-4) levels in pregnancies with late-onset fetal growth restriction (LO-FGR) versus healthy controls and to assess their correlation with Doppler ultrasound parameters and neonatal outcomes.

Materials and Methods

This case–control study was conducted at Ankara Etlik City Hospital and included 47 pregnant women with LO-FGR between 32 and 37 weeks of gestation and 43 age and gestational week-matched controls. Maternal serum TSP-4 concentrations were quantified using ELISA. Fetal biometric data, Doppler parameters, and neonatal outcomes were documented. The diagnostic effectiveness of TSP-4 levels in forecasting LO-FGR was assessed by ROC analysis. Furthermore, LO-FGR cases were divided based on composite adverse perinatal outcomes (CAPO) and compared in terms of clinical, sonographic, and TSP-4 levels.

Results

Maternal TSP-4 levels were markedly reduced in the LO-FGR group (p = 0.011). TSP-4 negatively correlated with LO-FGR (r = –0.269) and positively correlated with gestational age (r = 0.267), abdominal circumference (r = 0.257), and estimated fetal weight (r = 0.290). ROC analysis revealed moderate diagnostic accuracy for TSP-4 in predicting LO-FGR (AUC = 0.661; 95% CI 0.552–0.759; p = 0.007), whereas the cerebroplacental ratio (CPR) showed the highest accuracy (AUC = 0.782; 95% CI 0.683–0.862; p < 0.001). TSP-4 levels did not significantly differ between LO-FGR cases with and without CAPO (p = 0.494).

Conclusion

Maternal serum TSP-4 levels were lower in LO-FGR cases and correlated favorably with fetal biometric measures. ROC analysis indicated that TSP-4 exhibited moderate selective capability in diagnosing LO-FGR; however, it showed no association with CAPO. TSP-4 may be a supplementary biomarker that enhances diagnostic precision when assessed with Doppler data.