SFlt-1/PlGF ratio as a prognostic marker of adverse outcomes in women with early-onset preeclampsia

Oliveira, Leandro Gustavo de [UNESP]Peraçoli, José Carlos [UNESP]Peraçoli, Maria Terezinha Serrão [UNESP]Korkes, HenriZampieri, GiafrancoMoron, Antonio F.Sass, Nelson2014-05-272014-05-272013-07-01Pregnancy Hypertension, v. 3, n. 3, p. 191-195, 2013.2210-7789http://hdl.handle.net/11449/75775Soluble fms-like tyrosine kinase 1 (sFlt-1) is an anti-angiogenic factor released in higher amounts by preeclamptic placentas and it has been implicated in the endothelial dysfunction observed in the disease. In this study we evaluated if circulating sFlt-1/PlGF ratio is useful to predict adverse outcomes in women with early-onset preeclampsia. This is a cohort study of 88 preeclamptic women with singleton pregnancies at ≤35 weeks of gestation. According to definitions used, adverse outcomes occurred in 46.5% (N = 43) of the patients. The median sFlt1/PlGF ratio (25th-75th centile) for all patients evaluated was of 42.26 (13.1-226.1). The median sFlt-1/PlGF ratio among women who had any adverse outcome (N = 43) versus no adverse outcomes (N = 45) was of 227.6 (80.3-346.1) versus 14.4 (3.35-30.0), (P < 0.0001). According to our analyses a sFlt-1/PlGF ratio cut-point of ≥85 gave a sensitivity of 74.0% and specificity of 97.0%. The positive predictive value and the negative predictive value were 96.0% and 80.0%, respectively. The median sFlt-1/PlGF ratio (25th-75th centile) for patients who delivered within <7 days was 260.0 (127.7-404.7) as compared to 14.4 (3.35-34.97) for those patients who delivered within two weeks or more (P < 0.0001). Our results suggest that sFlt-1/PlGF ratio is a promising marker for adverse outcomes in women with early-onset preeclampsia. © 2013 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.191-195engInflammationPlGFPreeclampsiasFlt-1placental growth factorvasculotropin receptor 1adultBrazilcohort analysiscontrolled studydiagnostic test accuracy studydisease markerfemalegestational agehumanmajor clinical studypredictive valuepreeclampsiapregnancy outcomepriority journalprognosisprotein blood levelreceiver operating characteristicsensitivity and specificitySFlt-1/PlGF ratio as a prognostic marker of adverse outcomes in women with early-onset preeclampsiaArtigo10.1016/j.preghy.2013.02.003Acesso restrito2-s2.0-84878870151849943738159561407207948203259136486557387397806