{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:22:47Z","timestamp":1783516967346,"version":"3.55.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HL154254"],"award-info":[{"award-number":["HL154254"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HL179583"],"award-info":[{"award-number":["HL179583"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R41NS139906"],"award-info":[{"award-number":["R41NS139906"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Glob. Women\u2019s Health"],"abstract":"<jats:p>\n                    Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality, highlighting the need for effective methods to detect early identification and intervention. Previous data demonstrates that endothelial cilia, a microtubule-based organelle is responsible for vascular stability. Thus, we rationalized that proteins inside endothelial cilia may be candidates for conditions affected by dysregulated flow and barrier formation. Protein expression of four ciliary-associated candidates, including Platelet-Derived Growth Factor-BB (PDGF-BB), were quantified using Western blot and enzyme-linked immunosorbent assay (ELISA). Baseline characteristics were compared across groups, and logistic regression and receiver operating characteristic (ROC) analyses were performed to evaluate the association between PDGF-BB levels and PPH risk. Baseline characteristics were comparable across groups, except for maternal race and pre-pregnancy body mass index. Among the proteins evaluated, PDGF-BB demonstrated consistent differential expression across both analytical platforms. Higher PDGF-BB levels were independently associated with a lower risk of PPH in both unadjusted and adjusted models (adjusted OR 0.62, 95% CI 0.44\u20130.88;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0068). ROC analysis identified a PDGF-BB threshold of 11.5 pg\/mL, yielding high discriminatory performance for PPH. These findings may suggest that low levels of PDGF-BB may be associated with risk of PPH, providing a potential early biomarker for this condition to inform management. Further prospective studies are needed to confirm the temporal relationship, causal pathway, and diagnostic utility of PDGF-BB for risk of PPH.\n                  <\/jats:p>","DOI":"10.3389\/fgwh.2026.1849806","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T05:56:04Z","timestamp":1781675764000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["PDGF-BB as a potential biomarker for early diagnosis of postpartum hemorrhage"],"prefix":"10.3389","volume":"7","author":[{"given":"Karthikeyan","family":"Thirugnanam","sequence":"first","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Developmental Vascular Biology Program, Medical College of Wisconsin, Children\u2019s Research Institute (CRI)","place":["Milwaukee, WI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brock E.","family":"Polnaszek","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Medical College of Wisconsin","place":["Milwaukee, WI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Eng","sequence":"additional","affiliation":[{"name":"CIAN, Inc.","place":["Pewaukee, WI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy Y.","family":"Pan","sequence":"additional","affiliation":[{"name":"Division of Bioinformatics and Quantitative Child Health, Department of Pediatrics, Medical College of Wisconsin, CRI","place":["Milwaukee, WI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramani","family":"Ramchandran","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Developmental Vascular Biology Program, Medical College of Wisconsin, Children\u2019s Research Institute (CRI)","place":["Milwaukee, WI, United States"]},{"name":"CIAN, Inc.","place":["Pewaukee, WI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e323","DOI":"10.1016\/S2214-109X(14)70227-X","article-title":"Global causes of maternal death: a WHO systematic analysis","volume":"2","author":"Say","year":"2014","journal-title":"Lancet Glob Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1721550","DOI":"10.3389\/frph.2025.1721550","article-title":"Global burden, disparities, and determinants of postpartum haemorrhage among women who gave birth: an umbrella review of systematic reviews and meta-analyses","volume":"7","author":"Demissie","year":"2025","journal-title":"Front Reprod Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1097\/AOG.0000000000004972","article-title":"Postpartum hemorrhage trends and outcomes in the United States, 2000-2019","volume":"141","author":"Corbetta-Rastelli","year":"2023","journal-title":"Obstet Gynecol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1969","DOI":"10.1016\/S0140-6736(25)01639-3","article-title":"Prognostic accuracy of clinical markers of postpartum bleeding in predicting maternal mortality or severe morbidity: a WHO individual participant data meta-analysis","volume":"406","author":"Gallos","year":"2025","journal-title":"Lancet"},{"key":"B5","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1053\/j.semperi.2018.11.003","article-title":"Postpartum hemorrhage: early identification challenges","volume":"43","author":"Andrikopoulou","year":"2019","journal-title":"Semin Perinatol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1097\/AOG.0b013e3182941c78","article-title":"Clinical validation of risk stratification criteria for peripartum hemorrhage","volume":"122","author":"Dilla","year":"2013","journal-title":"Obstet Gynecol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1111\/j.1548-1433.2011.01351.x","article-title":"Framing postpartum hemorrhage as a consequence of human placental biology: an evolutionary and comparative perspective","volume":"113","author":"Abrams","year":"2011","journal-title":"Am Anthropol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/S1043-2760(01)00379-4","article-title":"Regulation of angiogenesis in the endometrium","volume":"12","author":"Smith","year":"2001","journal-title":"Trends Endocrinol Metab"},{"key":"B9","doi-asserted-by":"publisher","first-page":"2806","DOI":"10.1161\/ATVBAHA.118.311231","article-title":"Characterization of endothelial cilia distribution during cerebral-vascular development in zebrafish (danio rerio)","volume":"38","author":"Eisa-Beygi","year":"2018","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e202503460","DOI":"10.26508\/lsa.202503460","article-title":"Brain vascular stability relies on PAK2-cilia-PDGF-BB-HSPGs on basolateral side of endothelium","volume":"9","author":"Prabhudesai","year":"2026","journal-title":"Life Sci Alliance"},{"key":"B11","doi-asserted-by":"publisher","first-page":"115143","DOI":"10.1016\/j.bcp.2022.115143","article-title":"Ciliogenesis mechanisms mediated by PAK2-ARL13B signaling in brain endothelial cells is responsible for vascular stability","volume":"202","author":"Thirugnanam","year":"2022","journal-title":"Biochem Pharmacol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1093\/cvr\/cvt084","article-title":"Flow detection and calcium signalling in vascular endothelial cells","volume":"99","author":"Ando","year":"2013","journal-title":"Cardiovasc Res"},{"key":"B13","doi-asserted-by":"publisher","first-page":"S56","DOI":"10.1016\/j.diff.2011.11.007","article-title":"Primary cilia as biomechanical sensors in regulating endothelial function","volume":"83","author":"Egorova","year":"2012","journal-title":"Differentiation"},{"key":"B14","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1016\/j.celrep.2014.01.032","article-title":"Endothelial cilia mediate low flow sensing during zebrafish vascular development","volume":"6","author":"Goetz","year":"2014","journal-title":"Cell Rep"},{"key":"B15","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1002\/dvdy.21472","article-title":"Primary cilia sensitize endothelial cells for fluid shear stress","volume":"237","author":"Hierck","year":"2008","journal-title":"Dev Dyn"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.1161\/CIRCULATIONAHA.107.710111","article-title":"Endothelial cilia are fluid shear sensors that regulate calcium signaling and nitric oxide production through polycystin-1","volume":"117","author":"Nauli","year":"2008","journal-title":"Circulation"},{"key":"B17","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1002\/jcp.22704","article-title":"Primary cilia regulates the directional migration and barrier integrity of endothelial cells through the modulation of hsp27 dependent actin cytoskeletal organization","volume":"227","author":"Jones","year":"2012","journal-title":"J Cell Physiol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1093\/cvr\/cvab165","article-title":"Primary cilia control endothelial permeability by regulating expression and location of junction proteins","volume":"118","author":"Diagbouga","year":"2022","journal-title":"Cardiovasc Res"},{"key":"B19","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1681\/ASN.2013121314","article-title":"Endothelial cilia are essential for developmental vascular integrity in zebrafish","volume":"26","author":"Kallakuri","year":"2015","journal-title":"J Am Soc Nephrol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1016\/j.celrep.2016.12.044","article-title":"Cilia control vascular mural cell recruitment in vertebrates","volume":"18","author":"Chen","year":"2017","journal-title":"Cell Rep"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e151813","DOI":"10.1172\/jci.insight.151813","article-title":"Cilia proteins are biomarkers of altered flow in the vasculature","volume":"7","author":"Gupta","year":"2022","journal-title":"JCI Insight"},{"key":"B22","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1161\/ATVBAHA.107.161521","article-title":"Endothelial-mural cell signaling in vascular development and angiogenesis","volume":"29","author":"Gaengel","year":"2009","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1111\/1471-0528.16379","article-title":"Predicting risk of postpartum haemorrhage: a systematic review","volume":"128","author":"Neary","year":"2021","journal-title":"BJOG"},{"key":"B24","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1101\/gad.398207","article-title":"Defective N-sulfation of heparan sulfate proteoglycans limits PDGF-BB binding and pericyte recruitment in vascular development","volume":"21","author":"Abramsson","year":"2007","journal-title":"Genes Dev"},{"key":"B25","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.cytogfr.2004.03.005","article-title":"Insight into the physiological functions of PDGF through genetic studies in mice","volume":"15","author":"Betsholtz","year":"2004","journal-title":"Cytokine Growth Factor Rev"},{"key":"B26","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1161\/01.RES.84.3.298","article-title":"Endothelial cells modulate the proliferation of mural cell precursors via platelet-derived growth factor-BB and heterotypic cell contact","volume":"84","author":"Hirschi","year":"1999","journal-title":"Circ Res"},{"key":"B27","doi-asserted-by":"publisher","first-page":"805","DOI":"10.1083\/jcb.141.3.805","article-title":"PDGF, TGF-beta, and heterotypic cell-cell interactions mediate endothelial cell-induced recruitment of 10T1\/2 cells and their differentiation to a smooth muscle fate","volume":"141","author":"Hirschi","year":"1998","journal-title":"J Cell Biol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"219","DOI":"10.3109\/08977199209026929","article-title":"The expression of PDGF alpha- and beta-receptors in subpopulations of PDGF-producing cells implicates autocrine stimulatory loops in the control of proliferation in cytotrophoblasts that have invaded the maternal endometrium","volume":"6","author":"Holmgren","year":"1992","journal-title":"Growth Factors"},{"key":"B29","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1242\/dev.113.3.749","article-title":"Angiogenesis during human extraembryonic development involves the spatiotemporal control of PDGF ligand and receptor gene expression","volume":"113","author":"Holmgren","year":"1991","journal-title":"Development"},{"key":"B30","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/j.rbmo.2022.02.005","article-title":"Platelet-derived growth factor BB is reduced in endometrial endothelial cells of women with abnormal uterine bleeding-endometrial disorder","volume":"45","author":"Biswas Shivhare","year":"2022","journal-title":"Reprod Biomed Online"},{"key":"B31","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1002\/mrd.1080270203","article-title":"Expression of the insulin-like and platelet-derived growth factor genes in human uterine tissues","volume":"27","author":"Boehm","year":"1990","journal-title":"Mol Reprod Dev"},{"key":"B32","doi-asserted-by":"publisher","first-page":"2632","DOI":"10.1161\/ATVBAHA.120.314948","article-title":"Defining endothelial cell-derived factors that promote pericyte recruitment and capillary network assembly","volume":"40","author":"Kemp","year":"2020","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"4720","DOI":"10.1182\/blood-2010-05-286872","article-title":"Endothelial-derived PDGF-BB and HB-EGF coordinately regulate pericyte recruitment during vasculogenic tube assembly and stabilization","volume":"116","author":"Stratman","year":"2010","journal-title":"Blood"},{"key":"B34","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/j.clnu.2012.07.003","article-title":"Patients affected by metabolic syndrome show decreased levels of circulating platelet derived growth factor (PDGF)-BB","volume":"32","author":"Tisato","year":"2013","journal-title":"Clin Nutr"},{"key":"B35","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1186\/1471-2393-12-112","article-title":"Maternal obesity and postpartum haemorrhage after vaginal and caesarean delivery among nulliparous women at term: a retrospective cohort study","volume":"12","author":"Fyfe","year":"2012","journal-title":"BMC Pregnancy Childbirth"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1416990","DOI":"10.3389\/fimmu.2024.1416990","article-title":"Novel biomarkers for prediction of atonic postpartum hemorrhage among \u2018low-risk\u2019 women in labor","volume":"15","author":"Zhang","year":"2024","journal-title":"Front Immunol"}],"updated-by":[{"DOI":"10.3389\/fgwh.2026.1913342","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000}}],"container-title":["Frontiers in Global Women's Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgwh.2026.1849806\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T12:59:57Z","timestamp":1783515597000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgwh.2026.1849806\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,17]]},"references-count":36,"alternative-id":["10.3389\/fgwh.2026.1849806"],"URL":"https:\/\/doi.org\/10.3389\/fgwh.2026.1849806","relation":{},"ISSN":["2673-5059"],"issn-type":[{"value":"2673-5059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,17]]},"article-number":"1849806"}}