Impact of placental angiogenesis disorders and maternal metabolomic profile on pregnancy course and outcomes

Introduction. A favorable pregnancy outcome is determined by normally functioning fetoplacental complex. Complications such as preeclampsia (РЕ) and fetal growth restriction (FGR) are associated with disturbed placental angiogenesis and systemic changes in maternal metabolism posing a risk of perinatal pathology.

Aim: to systematize data regarding a relationship between disorders of placental angiogenesis and alterations in the maternal metabolomic profile, substantiating their combined impact on developing pregnancy complications.

Results. An imbalanced angiogenic factors is a central pathogenetic mechanism that includes: increased soluble fms-like tyrosine kinase-1 (sFlt-1) and decreased placental growth factor (PlGF) level. This leads to endothelial dysfunction, oxidative stress, and systemic inflammation. Metabolomics analysis reveals specific shifts: in РЕ – disturbed phospholipid and amino acid metabolism (arginine, isoleucine); in FGR – altered amino acid and energy metabolism; in gestational diabetes mellitus – early changes in lipid profile and acylcarnitines. These metabolic disturbances often precede clinical manifestation. Combined multi-marker panels, incorporating angiogenic and metabolic biomarkers, demonstrate superior diagnostic and prognostic accuracy compared to individual markers.

Conclusion. Integrative assessment of angiogenic and metabolic markers lays a foundation for early preclinical diagnosis, risk stratification, and the development of targeted therapeutic strategies. Implementing multi-marker panels into clinical practice can markedly improve quality of pregnancy monitoring, prediction of pregnancy outcomes, and ensure timely intervention.

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