Value of soluble fms-like tyrosine kinase-1/placental growth factor test in third trimester of pregnancy for predicting preeclampsia in asymptomatic women

J Perinat Med. 2022 May 13;50(7):939-946. doi: 10.1515/jpm-2022-0127. Print 2022 Sep 27.

Abstract

Objectives: To estimate the value of screening maternal serum soluble fms-like tyrosine kinase/placental growth factor (sFlt-1/PlGF) ratio in asymptomatic women during 3rd trimester to predict preeclampsia (PE) development.

Methods: The investigated group comprised of 178 pregnant women. During this gestation, 24 cases had developed PE and 12 isolated gestational hypertension (GH); whereas 142 remained normotensive. Blood samples were collected between 180 and 259 gestational days (g.d.) when the participants were asymptomatic. Serums were analyzed using the BRAHMS sFlt-1 Kryptor/BRAHMS PlGF plus Kryptor PE ratio test (Thermo Fisher Scientific, Henningdorf, Germany). High-risk pregnancies for the PE development were defined as sFlt-1/PlGF>38.

Results: The detection rate (DR) for manifestation of PE≤30 days after sampling was 83.3% and overall DR during pregnancy 58.3%. Ten of 15 women having false positive prediction of PE suffered from GH, preterm birth and/or delivery of a small-for-gestational-age-newborn. False positive rate was significantly higher at 239-253 g.d. compared to sampling at 210-224 g.d. and 225-238 g.d. (21.9% vs. 7.8% and 5.3%; p < 0.05).

Conclusions: The sFlt-1/PlGF test during 180-259 g.d. detected approximately half of subsequent PE cases. An optimal time to use the test for screening purposes was estimated 225-238 g.d. (DR 66.7%). False positive test results were more common to cases with other adverse pregnancy outcomes and samples drawn at higher gestational age.

Keywords: asymptomatic pregnant women; hypertension in pregnancy; preeclampsia; screening test; soluble fms-like tyrosine kinase/ placental growth factor (sFlt-1/PlGF) test.

MeSH terms

  • Biomarkers
  • Female
  • Humans
  • Hypertension, Pregnancy-Induced*
  • Infant, Newborn
  • Placenta Growth Factor
  • Pre-Eclampsia* / diagnosis
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Trimester, Third
  • Premature Birth*
  • Vascular Endothelial Growth Factor Receptor-1

Substances

  • Biomarkers
  • Placenta Growth Factor
  • Vascular Endothelial Growth Factor Receptor-1