European journal of obstetrics, gynecology, and reproductive biology · 2026
SPP1 improves early risk assessment of postpartum adverse events in pulmonary arterial hypertension complicated with pregnancy.
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Mu Li, Yuan Hui, Zhang Jun, Wu Junyi, Zhang Haofeng, Yang Jiashu
Аннотация
BACKGROUND: The postpartum period represents a critical window for women with pulmonary arterial hypertension (PAH), who face substantial risks of severe complications. However, effective biomarkers for postpartum risk stratification remain scarce. Secreted phosphoprotein 1 (SPP1), a key mediator of vascular remodeling and inflammation, may serve as a potential predictor in this context.
METHODS: Differential expression of SPP1 was validated using sequencing data from PAH patients. Plasma SPP1 concentrations were measured in an independent clinical cohort by ELISA. Receiver operating characteristic (ROC) analysis was performed to assess the predictive value of SPP1 alone and in combination with clinical parameters for postpartum adverse outcomes.
RESULTS: SPP1 expression was markedly upregulated in PAH patients. Postpartum adverse events were observed in 21 participants (34.4 %). Plasma SPP1 levels were significantly higher in the PAH group than in controls (49.16 vs. 22.69 ng/mL, p < 0.001) and in patients with adverse events compared to those without (63.56 vs. 39.61 ng/mL, p < 0.001). Elevated SPP1 concentrations correlated with disease severity (p = 0.0102). Incorporating SPP1 with clinical indicators such as BNP, NYHA class, and SPAP improved predictive accuracy (AUC = 0.761) compared with clinical markers alone (AUC = 0.698).
CONCLUSIONS: Increased SPP1 levels are associated with heightened postpartum risk in women with PAH. Combining SPP1 with conventional clinical measures enhances prognostic performance and may provide a valuable tool for individualized postpartum risk assessment and management.
METHODS: Differential expression of SPP1 was validated using sequencing data from PAH patients. Plasma SPP1 concentrations were measured in an independent clinical cohort by ELISA. Receiver operating characteristic (ROC) analysis was performed to assess the predictive value of SPP1 alone and in combination with clinical parameters for postpartum adverse outcomes.
RESULTS: SPP1 expression was markedly upregulated in PAH patients. Postpartum adverse events were observed in 21 participants (34.4 %). Plasma SPP1 levels were significantly higher in the PAH group than in controls (49.16 vs. 22.69 ng/mL, p < 0.001) and in patients with adverse events compared to those without (63.56 vs. 39.61 ng/mL, p < 0.001). Elevated SPP1 concentrations correlated with disease severity (p = 0.0102). Incorporating SPP1 with clinical indicators such as BNP, NYHA class, and SPAP improved predictive accuracy (AUC = 0.761) compared with clinical markers alone (AUC = 0.698).
CONCLUSIONS: Increased SPP1 levels are associated with heightened postpartum risk in women with PAH. Combining SPP1 with conventional clinical measures enhances prognostic performance and may provide a valuable tool for individualized postpartum risk assessment and management.