Retrospective evaluation of established cut-off values for the sFlt-1/PlGF ratio for predicting imminent delivery in preeclampsia patients

• Published in: Pregnancy hypertension Vol. 19; pp. 143 - 149
• Main Authors: Enengl, Sabine, Mayer, Richard B., Le Renard, Pol-Edern, Shebl, Omar, Arzt, Wolfgang, Oppelt, Peter
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.01.2020
• Subjects: Adult; Biomarkers - blood; Case-Control Studies; Delivery, Obstetric; Female; Gestational Age; Humans; Placenta Growth Factor - blood; Placental growth factor; Pre-Eclampsia - blood; Preeclampsia; Pregnancy; Retrospective Studies; sFlt-1/PlGF; Soluble fms-like tyrosine kinase-1; Time Factors; Time to delivery; Vascular Endothelial Growth Factor Receptor-1 - blood; sFlt-1/PlGF; AST; HELLP; ALT; Time to delivery; Soluble fms-like tyrosine kinase-1; IUGR; sFlt-1; Preeclampsia; ISSHP; PPROM; Placental growth factor; PlGF; sENG
• ISSN: 2210-7789; 2210-7797
• DOI: 10.1016/j.preghy.2020.01.009

•Patients showing a high sFlt-1/PlGF ratio are at high risk for imminent delivery.•Published cut-off values of sFlt-1/PlGF indicating delivery cannot be confirmed.•Decision-making on inducing delivery should be based on clinical criteria.•Laboratory findings can be used to guide clinical management. The outcome of preeclampsia is difficult to predict. Laboratory markers such as soluble fms-like tyrosine kinase (sFlt-1) and placental growth factor (PlGF) are thought to be predictive factors. A 2012 study by Verlohren et al. evaluated cut-off values for assessing time to delivery in patients with elevated sFlt-1/PlGF ratios. The present study aimed to evaluate findings in patients with elevated sFlt-1/PlGF ratios who gave birth at Kepler University Hospital in Linz, Austria. The hypothesis was tested, that our patients show longer pregnancy duration despite elevated sFlt-1/PlGF ratios. This retrospective data analysis included all patients with sFlt-1/PlGF ratios above the established cut-off values between January 2014 and October 2017. Two groups were analyzed relative to gestational age and were matched with healthy controls: 24 + 0 to 33 + 6 gestational weeks, sFlt-1/PlGF ratio >655.2; and 34 + 0 to 36 + 6 gestational weeks, sFlt-1/PlGF ratio >201. sFlt-1/PlGF ratio and time to delivery correlation. In the <34-week group, 43.2% of the patients delivered beyond 48 h, with a mean sFlt-1/PlGF ratio of 885.06, showing a significantly lower sFlt-1/PlGF ratio than patients who delivered within 2 days (P = 0.04). In the >34-week group, 66.7% were still pregnant after 48 h, with a mean sFlt-1/PlGF ratio of 273.7. The sFlt-1/PlGF ratio appears to be a powerful tool for diagnosing and predicting preeclampsia. However, the data do not confirm the cut-off values described earlier, with longer pregnancy durations in this group of patients.