First-trimester sFlt-1/PlGF ratio and oxidative stress markers in newborns: Biochemical associations and early risk stratification

Ulviyya Sirajli; Ellada Sariyeva; Sevda Guliyeva; Gubahanim Hajizade; Gultakin Javadova; Gulnar Babayeva; Farida  Gurbanova

doi:10.23750/abm.2026.18887

First-trimester sFlt-1/PlGF ratio and oxidative stress markers in newborns: Biochemical associations and early risk stratification

Authors

Ulviyya Sirajli Department of Obstetrics and Gynecology II, Azerbaijan Medical University, Baku, Azerbaijan
Ellada Sariyeva Department of Obstetrics and Gynecology II, Azerbaijan Medical University, Baku, Azerbaijan
Sevda Guliyeva Scientific Research Center, Azerbaijan Medical University, Baku, Azerbaijan
Gubahanim Hajizade Department of Obstetrics and Gynecology II, Azerbaijan Medical University, Baku, Azerbaijan
Gultakin Javadova Department of Obstetrics and Gynecology II, Azerbaijan Medical University, Baku, Azerbaijan
Gulnar Babayeva Department of Obstetrics and Gynecology II, Azerbaijan Medical University, Baku, Azerbaijan
Farida Gurbanova Department of Obstetrics and Gynecology II, Azerbaijan Medical University, Baku, Azerbaijan

Keywords:

preeclampsia, placenta, oxidative stress, malondialdehyde, angiogenic factors, infant, newborn, sFlt-1/PlGF ratio

Abstract

Background and Aim: Early disturbances in placental angiogenesis contribute to adverse pregnancy outcomes; however, their biochemical impact on the newborn remains insufficiently understood. This study aimed to assess the association between first-trimester angiogenic markers (sFlt-1, PlGF, and the sFlt-1/PlGF ratio, expressed as MoM) and oxidative stress parameters in newborns. Methods: A total of 48 pregnant women at 11–13 weeks of gestation and their newborns were included. Maternal serum levels of sFlt-1, PlGF, and the sFlt-1/PlGF ratio (MoM) were measured and used to stratify participants into normal, borderline, high-risk, and metabolic-risk groups. Neonatal biochemical parameters included glucose, malondialdehyde (MDA), and dicarbonyl compounds (DK). Statistical analysis involved ANOVA with post hoc tests, correlation analysis, and visualization methods. Results: Women in the high-risk group showed elevated sFlt-1 and sFlt-1/PlGF ratio and reduced PlGF (p < 0.01). Newborns of these mothers had higher MDA and DK levels (p < 0.05), indicating increased oxidative stress. A moderate positive correlation was found between maternal sFlt-1/PlGF ratio and neonatal DK (r = 0.42; p = 0.031), while MDA and DK were strongly correlated (r = 0.89; p < 0.001). The metabolic-risk group showed a distinct profile with elevated MoM and intermediate angiogenic changes. Conclusion: First-trimester angiogenic imbalance is associated with oxidative stress in newborns. Early angiogenic markers may serve as predictors of neonatal oxidative imbalance, supporting the concept of a maternal–placental–fetal axis. Integration of angiogenic and metabolic markers may improve prediction of perinatal risks.

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