(254) PDGF-BB as a Potential Biomarker for Early Diagnosis of Postpartum Hemorrhage

Postpartum hemorrhage (PPH) remains a leading cause of maternal mortality globally. Current risk stratification models lack specificity and sensitivity. Platelet-derived growth factor-BB (PDGF-BB), a vascular stability cytokine was hypothesized to serve as a diagnosis biomarker for PPH, which this study investigated.

Study Design:
We conducted a retrospective analysis of 80 plasma samples collected after 21 weeks 0 days gestation but prior to delivery. Samples were selected based on diagnosis in tissue bank at delivery of PPH (n=23), PPH with preeclampsia (PPH+PE; n=6), and PE alone (n=41). Controls (n=10) were samples that had no diagnosis of PPH or PE (Table 1). PDGF-BB protein levels were assessed by ELISA and Western blot methods. Logistic regression analysis was used to evaluate the association between PDGF-BB and PPH.

Results:

Among the 80 plasma samples, body mass index was statistically significantly different among PPH, PPH+PE, PE and controls, p=0.047 (Table 1). ELISA assay results showed that PDGF-BB levels were significantly lower in PPH (median and interquartile range [7.5 (6.6, 9.3) pg/mL] and PPH+PE [6.7 (4.8, 10.8) pg/mL] compared to controls [22.9 (21.7, 24.5) pg/mL], adjusted p< 0.0001 and p=0.0015, respectively. PE alone group (22.3 pg/mL) showed no significant difference from controls. Western blot method confirmed ~1-fold reduction in PDGF-BB in PPH groups. Higher PDGF-BB levels were inversely associated with PPH risk [OR 0.62, 95% CI: 0.44–0.88; p=0.0068]. ROC analysis identified a PDGF-BB cutoff of 11.5 pg/mL with 100% sensitivity and specificity (AUC=1.0) (Figure 1).

Conclusion:
Low antepartum plasma PDGF-BB levels were significantly associated with PPH and demonstrated high diagnostic performance at a defined threshold. These findings support PDGF-BB as a promising early biomarker for PPH risk stratification. Prospective validation in larger, diverse cohorts is warranted to assess clinical applicability and potential integration into management of obstetric hemorrhage.