Endoglin, PlGF and sFlt-1 as markers for predicting pre-eclampsia

• Published in: Acta obstetricia et gynecologica Scandinavica Vol. 87; no. 8; pp. 837 - 842
• Main Authors: De Vivo, Antonio, Baviera, Giovanni, Giordano, Domenico, Todarello, Giovanna, Corrado, Francesco, D'anna, Rosario
• Format: Journal Article
• Language: English
• Published: Oxford, UK Informa UK Ltd 01.01.2008; Blackwell Publishing Ltd
• Subjects: Adult; Antigens, CD - blood; Biomarkers - blood; Cohort Studies; Endoglin; Female; Humans; Placenta Growth Factor; Plgf; pre-eclampsia; Pre-Eclampsia - blood; Pre-Eclampsia - diagnosis; Pre-Eclampsia - etiology; Predictive Value of Tests; Pregnancy; Pregnancy Proteins - blood; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Receptors, Cell Surface - blood; Risk Factors; sFlt-1; Vascular Endothelial Growth Factor Receptor-1 - blood
• ISSN: 0001-6349; 1600-0412
• DOI: 10.1080/00016340802253759

Objective. To evaluate the ability of endoglin, placental growth factor (PlGF) and the soluble form of vascular endothelial growth factor receptor (sFlt-1) measurements in gestational weeks 24-28 were used to predict pre-eclampsia. Design. Observational, prospective study. Setting. Department of Gynecological, Obstetrical Sciences and Reproductive Medicine, University of Messina. Sample. Fifty-two pre-eclamptic and 52 healthy pregnant women. Methods. A maternal serum sample was frozen and stored at 1-h 50-g glucose challenge test between 24 and 28 weeks' gestation. A second maternal serum sample was collected at admission for the onset of the disease in the pre-eclamptic group and at admission for delivery in the control group. Levels of endoglin, sFlt-1 and the PlGF were measured in the stored serum. Pre-eclamptic subjects were also divided into women with early-onset (<37 weeks) and women with late-onset pre-eclampsia (≥37 weeks). Results. Levels of endoglin, sFlt-1, and sFlt-1:PlGF ratio were found to be higher in the pre-eclamptic group in both trimesters. No differences were found between early- and late-onset pre-eclamptic. The Receiver Operating Characteristics curve, applied to the second trimester marker values, showed the best diagnostic profile for sFlt-1:PlGF (area under the curve, AUC=0.92) followed by endoglin (AUC=0.88), sFlt-1 (AUC=0.87) and PlGF (AUC=0.83). This finding was confirmed by Bayesian analysis which highlighted a specificity, a sensitivity, a diagnostic accuracy, a positive predictive value and a negative predictive value of 88.5% for sFlt-1:PlGF using a cut-off of 38.47. Conclusions. Endoglin, PlGF and sFlt-1 might be used as markers for predicting pre-eclampsia, but sFlt-1:PlGF seems to be more accurate.