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

Ele Hanson; Kristiina Rull; Kaspar Ratnik; Pille Vaas; Pille Teesalu; Maris Laan

doi:10.1515/jpm-2022-0127

Article

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

Ele Hanson , Kristiina Rull , Kaspar Ratnik , Pille Vaas , Pille Teesalu and Maris Laan

Published/Copyright: May 13, 2022

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From the journal Journal of Perinatal Medicine Volume 50 Issue 7

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

Corresponding author: Prof. Maris Laan, Institute of Biomedicine and Translational Medicine, University of Tartu, Ravila St. 19,50411, Tartu, Estonia, Phone: +372 7375008, Fax: +372 53495258, E-mail: maris.laan@ut.ee

Funding source: Eesti Teadusagentuur

Award Identifier / Grant number: grants IUT34-12 and PRG1021

Funding source: European Regional Development Fund

Award Identifier / Grant number: 3.2.0701.12–0047

Funding source: University of Tartu, Institute of clinical medicine

Acknowledgments

We thank the HAPPY PREGNANCY study participants. The clinical and laboratory personnel at the Women’s Clinic and United Laboratories of Tartu University Hospital and Chair of Human Genetics, Institute of Biomedicine and Translational Medicine, University of Tartu are acknowledged for the assistance in recruitment, phenotyping, sample logistics and aliquoting.

Research funding: This work was supported by EU through the European Regional Development Fund (project HAPPY PREGNANCY, 3.2.0701.12–0047; for M.L and K.R), Estonian Research Council (grants IUT34-12 and PRG1021 for M.L) and Institute of Clinical Medicine (target funding for K.R). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the Ethics Committee of Human Research of the University Clinic of Tartu, Estonia (permissions no. 221/T-6, 17.12.2012 and 286/M-18, 15.10.2018).

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Received: 2021-12-12

Accepted: 2022-04-16

Published Online: 2022-05-13

Published in Print: 2022-09-27

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Articles in the same Issue

https://doi.org/10.1515/jpm-2022-0127

Keywords for this article

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