Association of D-dimer, platelet-activating factor, and soluble vascular endothelial growth factor receptor 1 levels with disease severity and prognosis in gestational hypertension

To investigate the associations of D-dimer (D-D), platelet-activating factor (PAF), and soluble vascular endothelial growth factor receptor 1 (sVEGFR-1) levels with disease severity and prognosis in hypertensive disorders complicating pregnancy (HDCP). A total of 138 HDCP patients were categorized as the gestational hypertension (GH, n = 62), preeclampsia (PE, n = 45), and severe preeclampsia (SPE, n = 31) groups. Fifty healthy pregnant women served as controls. Plasma D-D and serum PAF and sVEGFR-1 levels were measured and compared. ROC curves assessed their diagnostic and prognostic value. Based on neonatal Apgar score <7 or grade III amniotic fluid contamination, patients were divided into good (n = 73) and poor (n = 65) prognosis groups. D-D, PAF, and sVEGFR-1 levels increased with disease severity (all P<0.05). The AUCs for diagnosing HDCP severity were 0.893 (D-D), 0.889 (PAF), 0.825 (sVEGFR-1), and 0.944 (combined). Multivariate logistic regression identified D-D, PAF, sVEGFR-1, and 24h RPO as independent prognostic factors (all P<0.05). Combined AUC for prognosis prediction was 0.883. Elevated D-D, PAF, and sVEGFR-1 levels are closely associated with HDCP severity and prognosis, offering high diagnostic and predictive value.