Serum autoantibody panel as a novel predictor for preeclampsia: a nested case-control study

Preeclampsia is a severe pregnancy-related complication that poses a major threat to the health of both mothers and fetuses. Early identification of high-risk pregnant women remains one of the key clinical challenges. Previous studies have shown that excessive maternal inflammatory reactions and autoantibodies exist in patients with preeclampsia, but the specific roles of these factors in disease occurrence have not been clarified. The current study aims to explore whether measuring the levels of autoantibodies in pregnant women’s serum can provide a new basis for predicting the occurrence of preeclampsia. A nested case-control study, based on a prospectively maintained biobank, was conducted, and a total of 94 serum samples from pregnant women were collected, including 30 samples from healthy pregnant women, 10 samples from pregnant women diagnosed only with gestational hypertension, and 54 samples from pregnant women collected before clinical confirmation of preeclampsia. Using multiplex bead-based immunoassay, the levels of 20 autoantibodies in all samples were detected, and quantitative results were expressed as median fluorescence intensity. Statistical analyses were performed using non-parametric tests, ROC curve analysis, and multivariate Logistic regression to evaluate the predictive value of these autoantibodies for preeclampsia. Compared with pregnant women who did not develop preeclampsia (including the healthy control group and gestational hypertension group), the serum levels of anti-SSA/Ro60, anti-β2-glycoprotein I, anti-Jo-1, and anti-PL-12 in preeclampsia patients were significantly increased (p < 0.05). Among single indicators, anti-SSA/Ro60 showed the best predictive performance, with an AUC of 0.774 (95% CI: 0.676–0.871). Furthermore, a multivariate predictive model was constructed by integrating three indicators: anti-SSA/Ro60, anti-β2-glycoprotein I, and anti-Jo-1. The combined predictive performance was excellent, with the AUC increased to 0.832 (95% CI: 0.748–0.917), and the sensitivity and specificity reached 72.2% and 82.5%. Our findings suggest that detecting anti-SSA/Ro60, anti-β2-glycoprotein I, and anti-Jo-1 in pregnant women’s serum may serve as a potential approach for the risk stratification of preeclampsia. This non-invasive blood-based detection method helps identify high-risk populations for preeclampsia at an early stage, providing a reference for early clinical intervention.