Assessing placental endocrine and vascular function for prenatal prediction of adverse pregnancy outcomes in advanced‑maternal‑age pregnancies

Simultaneous mid-pregnancy assessment of endocrine (hCG, PAPP-A, sFlt-1/PlGF) and vascular (UtA-PI) placental function markedly improves prediction of pre-eclampsia and SGA in women of advanced maternal age, outperforming clinical or single-domain models and demonstrating practical decision-curve gains; integrating this dual-domain profile into routine prenatal care could facilitate targeted surveillance and prophylactic strategies to mitigate adverse outcomes.