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Войти в исследования Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2026
Soluble fms-Like Tyrosine Kinase-1 to Placental Growth Factor Ratio for the Prediction of Preeclampsia in Asymptomatic Women.
СтатьяНазвание и аннотация: Перевод в очереди
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Demuth Brielle, Cavalcanti Deborah, Guerby Paul, Pellan Ariane, Blouin Camille, Lévesque Anthony, Boutin Amélie, Giguère Yves, Forest Jean-Claude, Ghesquière Louise, Bujold Emmanuel
Аннотация
OBJECTIVES: The ratio of soluble fms-like tyrosine kinase-1 (sFlt-1) over placental growth factor (PlGF) increases before clinical onset in women with suspected preeclampsia (PE). We aimed to estimate its value in asymptomatic patients.
METHODS: We recruited nulliparous patients in the first trimester, invited to attend a 200-246 and 300-346 weeks' gestation visit for maternal blood sampling used for measurement of the sFlt-1/PlGF ratio (using B·R·A·H·M·S KRYPTOR analyzer). The primary outcome was PE stratified by gestational age at delivery: preterm (<37 weeks) subdivided into early (<34 weeks) and late (34-36 weeks) preterm; and term (≥37 weeks) PE. Analyses included area under the receiver operating characteristic curves and the Youden index.
RESULTS: Among 845 women recruited, 832 (98%) had complete data, including 4 (0.5%) early, 4 (0.5%) late-preterm, and 26 (3.1%) term PE. At 200-246 weeks gestation, the sFlt-1/PlGF ratio was highly associated with early (area under the receiver operating characteristic curve [AUC] 0.99; 95% CI 0.99-1.00; sensitivity: 100% specificity: 99%) but not late-preterm or term PE. At 300-346 weeks, the sFlt-1/PlGF ratio accurately discriminated preterm cases (AUC 0.96; 95% CI 0.89-1.00; sensitivity: 86% specificity: 98%) and moderately discriminated term cases (AUC 0.71; 95% CI 0.58-0.83; sensitivity: 42% specificity: 93%).
CONCLUSIONS: Maternal sFlt-1/PlGF ratio is increased at 20-24 weeks gestation among asymptomatic women who will develop early PE and at 30-34 weeks among those who will develop preterm PE. The discriminatory performance of the sFlt-1/PlGF ratio varies according to gestational age at screening and gestational age at delivery.
METHODS: We recruited nulliparous patients in the first trimester, invited to attend a 200-246 and 300-346 weeks' gestation visit for maternal blood sampling used for measurement of the sFlt-1/PlGF ratio (using B·R·A·H·M·S KRYPTOR analyzer). The primary outcome was PE stratified by gestational age at delivery: preterm (<37 weeks) subdivided into early (<34 weeks) and late (34-36 weeks) preterm; and term (≥37 weeks) PE. Analyses included area under the receiver operating characteristic curves and the Youden index.
RESULTS: Among 845 women recruited, 832 (98%) had complete data, including 4 (0.5%) early, 4 (0.5%) late-preterm, and 26 (3.1%) term PE. At 200-246 weeks gestation, the sFlt-1/PlGF ratio was highly associated with early (area under the receiver operating characteristic curve [AUC] 0.99; 95% CI 0.99-1.00; sensitivity: 100% specificity: 99%) but not late-preterm or term PE. At 300-346 weeks, the sFlt-1/PlGF ratio accurately discriminated preterm cases (AUC 0.96; 95% CI 0.89-1.00; sensitivity: 86% specificity: 98%) and moderately discriminated term cases (AUC 0.71; 95% CI 0.58-0.83; sensitivity: 42% specificity: 93%).
CONCLUSIONS: Maternal sFlt-1/PlGF ratio is increased at 20-24 weeks gestation among asymptomatic women who will develop early PE and at 30-34 weeks among those who will develop preterm PE. The discriminatory performance of the sFlt-1/PlGF ratio varies according to gestational age at screening and gestational age at delivery.