The role of the soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PIGF) – ratio in clinical practice in obstetrics: diagnostic and prognostic value

Daniela C.S. Melo; Raquel P. Sousa; Maria S.J.D.R. Pais; Luiza M. Felix; Filipe F. Pinto; José P.S.A. Moura

doi:10.1515/jpm-2022-0353

Article

The role of the soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PIGF) – ratio in clinical practice in obstetrics: diagnostic and prognostic value

Daniela C.S. Melo , Raquel P. Sousa , Maria S.J.D.R. Pais , Luiza M. Felix , Filipe F. Pinto and José P.S.A. Moura

Published/Copyright: May 8, 2023

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From the journal Journal of Perinatal Medicine Volume 51 Issue 7

Abstract

Objectives

Analyze the diagnostic and prognostic value of the sFlt-1/PlGF ratio in pregnant women with at least one sign/symptom of suspected/diagnosed pre-eclampsia.

Methods

This retrospective observational study included 170 pregnant women with at least one sign/symptom of pre-eclampsia, who had sFlt-1/PlGF ratio values. The following information was evaluated: pregnant women’s demographic data and clinical history; laboratory data (urine protein/creatinine ratio; sFlt-1/PlGF ratio); signs and symptoms presented; clinical outcome; fetal complications; data related to childbirth. Statistical analysis was performed by R Software Version 3.5.2.

Results

Among the 170 patients, 78 presented pre-eclampsia. The median sFlt-1/PlGF ratio was significantly higher [143.1 (2.2–2,927.1)] for women who presented pre-eclampsia than for women without pre-eclampsia [33.5 (0.8–400.2)]. The negative predictive value of sFlt-1/PlGF ratio <38 was 83.9 % (95 % CI, 71.7–92.4 %) and the positive predictive value of sFlt-1/PlGF ratio >85 or 110 (for late onset pre-eclampsia) was 76.4 % (95 % CI, 66.2–84.8 %). sFlt-1/PlGF >85 or 110 was associated with pre-eclampsia clinical development, fetal complications, shorter gestational age at birth, higher number of caesarean deliveries and lower birth weight.

Conclusions

The sFlt-1/PlGF ratio, together with the standard diagnostic criteria, can be used to rule out pre-eclampsia, identify high-risk patients and predict the occurrence of adverse outcomes.

Keywords: FLT1 protein; human; hypertension; placenta growth factor; pre-eclampsia; proteinuria

Corresponding author: Daniela C.S. Melo, Master Degree, Department of Obstetrics-A, Coimbra Hospital and University Centre, Coimbra, Praceta Professor Mota Pinto, 3004-561, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; and University Clinic of Gynecology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal, E-mail: dmelo_8@hotmail.com

Daniela C. S. Melo and Raquel P. Sousa contributed equally to this work (co-first authors).

Research funding: None declared.
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: Not applicable.
Ethical approval: The Ethics Committees of Centro Hospitalar e Universitário de Coimbra considered and approved the study presented in this paper (CHUC-182-20).

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Received: 2022-07-19

Accepted: 2023-03-25

Published Online: 2023-05-08

Published in Print: 2023-09-26

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Articles in the same Issue

https://doi.org/10.1515/jpm-2022-0353

Keywords for this article

FLT1 protein; human; hypertension; placenta growth factor; pre-eclampsia; proteinuria