{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:34:56Z","timestamp":1791527696391,"version":"4.3.4"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,8,17]]},"abstract":"<jats:sec xml:lang=\"en\"><jats:title>Background<\/jats:title><jats:p xml:lang=\"en\">We investigated the biomarker potential of growth differentiation factor 15 (GDF\u201015), a stress response protein highly expressed in placenta, to predict preeclampsia.<\/jats:p><\/jats:sec><jats:sec xml:lang=\"en\"><jats:title>Methods and Results<\/jats:title><jats:p xml:lang=\"en\">In 2 prospective cohorts (cohort 1: 960 controls, 39 women who developed preeclampsia; cohort 2: 950 controls, 41 developed preeclampsia), plasma concentrations of GDF\u201015 at 36\u00a0weeks' gestation were significantly increased among those who developed preeclampsia (<jats:italic>P<\/jats:italic>&lt;0.001), area under the receiver operating characteristic curves (AUC) of 0.66 and 0.71, respectively. In cohort 2 a ratio of sFlt\u20101\/PlGF (a clinical biomarker for preeclampsia) had a sensitivity of 61.0% at 83.2% specificity to predict those who will develop preeclampsia (AUC of 0.79). A ratio of GDF\u201015\u00d7sFlt\u20101\/PlGF yielded a sensitivity of 68.3% at 83.2% specificity (AUC of 0.82). GDF\u201015 was consistently elevated across a number of international cohorts: levels were higher in placenta and blood from women delivering &lt;34\u00a0weeks' gestation due to preterm preeclampsia in Melbourne, Australia; and in the blood at 26 to 32\u00a0weeks' gestation among 57 women attending the Manchester Antenatal Vascular Service (MAViS, UK) who developed preeclampsia (<jats:italic>P<\/jats:italic>=0.0002), compared with 176 controls. In the Preeclampsia Obstetric adVerse Events biobank (PROVE, South Africa), plasma GDF\u201015 was significantly increased in women with preeclampsia with severe features (<jats:italic>P<\/jats:italic>=0.02; n=14) compared to controls (n=14).<\/jats:p><\/jats:sec><jats:sec xml:lang=\"en\"><jats:title>Conclusions<\/jats:title><jats:p xml:lang=\"en\">We conclude circulating GDF\u201015 is elevated among women more likely to develop preeclampsia or diagnosed with the condition. It may have value as a clinical biomarker, including the potential to improve the sensitivity of sFlt\u20101\/PlGF ratio.<\/jats:p><\/jats:sec>","DOI":"10.1161\/jaha.120.020302","type":"journal-article","created":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T09:38:31Z","timestamp":1628847511000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Circulating Growth Differentiation Factor 15 Is Increased Preceding Preeclampsia Diagnosis: Implications as a Disease Biomarker"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0625-8251","authenticated-orcid":false,"given":"Tess","family":"Cruickshank","sequence":"first","affiliation":[{"name":"Translational Obstetrics Group Mercy Hospital for Women Heidelberg Victoria Australia"},{"name":"The Department of Obstetrics and Gynaecology Mercy Hospital for WomenUniversity of Melbourne 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