Objective: Isolated gestational proteinuria (IGP) has traditionally been considered a benign condition; however, emerging evidence suggests that it may represent an early stage in the spectrum of preeclampsia. This study aimed to evaluate clinical and laboratory predictors of progression from IGP to preeclampsia. Methods: This retrospective cohort study included pregnant women diagnosed with proteinuria ≥ 300 mg/day after 20 weeks of gestation between January 2023 and December 2024. After applying predefined exclusion criteria, 319 women with isolated gestational proteinuria (IGP) were included and stratified according to progression to preeclampsia (n = 42, 17.8%). Baseline clinical and laboratory parameters were compared between groups. Multivariable logistic regression analysis was performed to identify independent predictors of progression, and receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminative performance of significant variables. Results: Preeclampsia developed in 17.8% of women with IGP. In multivariable analysis, higher maternal body mass index (aOR 1.085, p = 0.028) and earlier gestational age at diagnosis (aOR 0.883, p = 0.011) were identified as independent predictors of progression. Although neutrophil count and systemic inflammatory indices were elevated in univariate analyses, they did not retain independent predictive value after adjustment. Conclusions: In pregnancies complicated by isolated gestational proteinuria, clinical parameters appear to be more informative than inflammatory and renal markers for predicting progression to preeclampsia. Laboratory-derived indices offer limited additional value and should be interpreted cautiously in risk assessment.

Diagnostic and prognostic role of maternal serum prokineticin-1 in preeclampsia and adverse pregnancy outcomes - Journal of the Turkish-German Gynecological Association

Objective: To evaluate the clinical significance of a flat oral glucose tolerance test (OGTT) pattern and its association with obstetric and perinatal outcomes, focusing on fetal growth. Methods: This retrospective cohort study was conducted at a tertiary referral center between January 2023 and November 2025. A total of 1198 women who underwent a two-step OGTT between 24 and 32 weeks of gestation were screened, and 685 eligible participants were included. A flat OGTT pattern was defined as fasting glucose < 95 mg/dL with all postprandial values < 100 mg/dL. The primary outcome was small-for-gestational-age (SGA); secondary outcomes included fetal growth restriction (FGR) and other obstetric outcomes. Logistic regression analyses were performed to assess independent associations. Results: Thirty-nine women (5.7%) exhibited a flat OGTT pattern. These pregnancies were characterized by a markedly attenuated postprandial glycemic response and lower fasting glucose levels. Most maternal and neonatal outcomes were similar between groups. However, SGA was significantly more frequent in the flat OGTT group (20.5% vs. 6.7%, p = 0.001). In multivariable analysis, a flat OGTT pattern remained independently associated with SGA (aOR 4.05, 95% CI 1.70–9.68, p = 0.002). Both SGA and FGR were more frequent among women with a flat OGTT pattern, although the association appeared stronger for SGA. Conclusions: A flat OGTT pattern appears to represent a distinct glycemic response characterized by an attenuated postprandial glucose response and lower fasting glucose levels. Although this pattern was not associated with a generalized increase in adverse obstetric or neonatal outcomes, it was associated with an increased risk of small-for-gestational-age infants.

Aim: Placenta accreta spectrum (PAS) is a severe obstetric condition characterized by abnormal trophoblast invasion and increased maternal morbidity. Laeverin (LVN), a trophoblast-specific peptidase involved in cell invasion, has been implicated in placental pathophysiology. This study aimed to evaluate maternal serum LVN levels in pregnancies complicated by PAS and to assess its diagnostic and discriminative utility. Materials and Methods: This prospective case–control study included 88 pregnant women (44 with PAS and 44 gestational age and BMI matched controls) managed at a tertiary center between July 2025 and March 2026. PAS diagnosis was established by ultrasonography and confirmed intraoperatively and histopathologically. Maternal serum LVN levels were measured using ELISA. Receiver operating characteristic (ROC) analysis and regression analyses were performed. Results: Maternal serum LVN levels did not differ between PAS and control groups (0.07 vs. 0.06 ng/mL, p = 0.401) and were not associated with PAS severity or clinical outcomes. ROC analysis showed poor discriminative ability (AUC = 0.552, p = 0.404). In contrast, maternal age (aOR: 1.106, 95% CI: 1.004–1.219, p = 0.042) and previous cesarean section history (aOR: 3.757, 95% CI: 1.800–7.841, p < 0.001) were independent predictors of PAS. Conclusion: Maternal serum LVN levels did not differ between PAS and healthy pregnancies and did not demonstrate meaningful diagnostic or diagnostic utility in this cohort. These findings highlight the limited utility of circulating biomarkers and emphasize the importance of established clinical risk factors in PAS diagnostic utility.