Soluble fms-Like Tyrosine Kinase-1-to-Placental Growth Factor Ratio and Time to Delivery in Women With Suspected Preeclampsia
2016 (English)In: Obstetrics and Gynecology, ISSN 0029-7844, E-ISSN 1873-233X, Vol. 128, no 2, 261-269 p.Article in journal (Refereed) Published
OBJECTIVE: To assess the association of a serum soluble fms-like tyrosine kinase 1-to-placental growth factor (sFlt-1-to-PlGF) ratio of greater than 38 with time to delivery and preterm birth.
METHODS: Secondary analysis of an observational cohort study that included women 18 years of age or older from 24 to 36 6/7 weeks of gestation at their first study visit with suspected (not confirmed) preeclampsia. Participants were recruited from December 2010 to January 2014 at 30 sites in 14 countries. A total of 1,041 women were included in time-to-delivery analysis and 848 in preterm birth analysis.
RESULTS: Women with an sFlt-1-to-PlGF ratio greater than 38 (n=250) had a 2.9-fold greater likelihood of imminent delivery (ie, delivery on the day of the test) (Cox regression hazard ratio 2.9; P <.001) and shorter remaining time to delivery (median 17 [interquartile range 10-26] compared with 51 [interquartile range 3075] days, respectively; Weibull regression factor 0.62; P <.001) than women with an sFlt-1-to-PlGF ratio of 38 or less, whether or not they developed preeclampsia. For women who did not (n=842) and did develop preeclampsia (n=199), significant correlations were seen between an sFlt-1-to-PlGF ratio greater than 38 and preterm birth (r=0.44 and r=0.46; both P <.001). Among women who did not develop preeclampsia, those who underwent iatrogenic preterm delivery had higher median sFlt-1-to-PlGF ratios at their first visit (35.3, interquartile range 6.8-104.0) than those who did not (8.4, interquartile range 3.4-30.6) or who delivered at term (4.3, interquartile range 2.4-10.9).
CONCLUSIONS: In women undergoing evaluation for suspected preeclampsia, a serum sFlt-1-to-PlGF ratio greater than 38 is associated with a shorter remaining pregnancy duration and a higher risk of preterm delivery.
Place, publisher, year, edition, pages
2016. Vol. 128, no 2, 261-269 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-303111DOI: 10.1097/AOG.0000000000001525ISI: 000380918500008PubMedID: 27399996OAI: oai:DiVA.org:uu-303111DiVA: diva2:1032913
European Congress of the International-Society-for-the-Study-of-Hypertension-in-Pregnancy (ISSHP), SEP 24-25, 2015, Budapest, HUNGARY