Meta-Analysis and Systematic Review to Assess the Role of Soluble FMS-Like Tyrosine Kinase-1 and Placenta Growth Factor Ratio in Prediction of Preeclampsia: The SaPPPhirE Study. Issue 2 (February 2018)

• Record Type: Journal Article
• Authors: Agrawal, Swati; Cerdeira, Ana Sofia; Redman, Christopher; Vatish, Manu
• Is Part Of: Hypertension. Volume 71:Issue 2(2018:Feb.)
• Publication Date: 2018-02
• Subjects: biomarkers -- placenta growth factor -- preeclampsia -- pregnancy -- sFLT-1 protein, human; Hypertension -- Periodicals; Hypertension -- Treatment -- Periodicals; 616.132005
• DOI: 10.1161/HYPERTENSIONAHA.117.10182
• Languages: English
• ISSNs: 0194-911X

Abstract

Abstract : Preeclampsia is a major cause of morbidity and mortality worldwide. Numerous candidate biomarkers have been proposed for diagnosis and prediction of preeclampsia. Measurement of maternal circulating angiogenesis biomarker as the ratio of sFlt-1 (soluble FMS-like tyrosine kinase-1; an antiangiogenic factor)/PlGF (placental growth factor; an angiogenic factor) reflects the antiangiogenic balance that characterizes incipient or overt preeclampsia. The ratio increases before the onset of the disease and thus may help in predicting preeclampsia. We conducted a meta-analysis to explore the predictive accuracy of sFlt-1/PlGF ratio in preeclampsia. We included 15 studies with 534 cases with preeclampsia and 19 587 controls. The ratio has a pooled sensitivity of 80% (95% confidence interval, 0.68–0.88), specificity of 92% (95% confidence interval, 0.87–0.96), positive likelihood ratio of 10.5 (95% confidence interval, 6.2–18.0), and a negative likelihood ratio of 0.22 (95% confidence interval, 0.13–0.35) in predicting preeclampsia in both high- and low-risk patients. Most of the studies have not made a distinction between early- and late-onset disease, and therefore, the analysis for it could not be done. It can prove to be a valuable screening tool for preeclampsia and may also help in decision-making, treatment stratification, and better resource allocation. Abstract : Supplemental Digital Content is available in the text.