Abstract
Aims: We aimed to investigate the level and predictive value of soluble nectin-4 in early onset preeclampsia (EOPE).
 Methods: Forty-three patients with EOPE and 41 healthy normotensive pregnant women participated in this prospective case-control study. The groups were matched for gestational age and gravidity. Serum nectin-4 levels were compared between groups. The ROC curve was drawn to show the predictive value of nectin-4 for EOPE. Patients were followed up until the end of labor, and perinatal outcomes were recorded.
 Results: The demographic characteristics of the two groups were similar. Serum nectin-4 level was significantly increased in EOPE cases compared to controls (226.46±119.6 ng/ml vs. 156.54±44.8 ng/ml, p=0.001). The ROC showed that at > 160.938, the sensitivity and specificity were 67.44% and 82.93%, respectively [AUC:0.822, (CI:0.724 - 0.897), and (p< 0.001)]. Significant inverse correlations were found between nectin-4 levels and poor obstetric outcomes.
 Conclusion: Maternal serum nectin-4 levels were significantly higher in patients with EOPE compared with controls. Increased nectin-4 levels may contribute to the development of EOPE through possible oxidative, immunological, and inflammatory mechanisms adversely affecting trophoblastic cells.
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