SFlt-1 to PlGF ratio cut-offs to predict adverse pregnancy outcomes in early-onset FGR and SGA: a prospective observational study. (3rd October 2022)

• Record Type: Journal Article
• Authors: Bonacina, Erika; Armengol-Alsina, Mireia; Hurtado, Ivan; Garcia-Manau, Pablo; Ferrer-Oliveras, Raquel; Monreal, Sonia; Pancorbo, Maria; Mendoza, Manel; Carreras, Elena
• Is Part Of: Journal of obstetrics and gynaecology. Volume 42:Number 7(2022)
• Page Start: 2840
• Page End: 2845
• Publication Date: 2022-10-03
• Subjects: Adverse pregnancy outcomes -- angiogenic factors -- foetal growth restriction -- placental growth factor -- small for gestational age -- soluble fms-like tyrosine kinase-1; Obstetrics -- Periodicals; Gynecology -- Periodicals; 618.05
• DOI: 10.1080/01443615.2022.2109956
• Languages: English
• ISSNs: 0144-3615

Abstract

Abstract: This is a prospective, observational study, conducted in a tertiary referral hospital. We enrolled 175 singleton pregnancies with estimated foetal weight below the 10th centile between 20 + 0 and 31 + 6 weeks. Placental growth factor (PlGF), soluble fms‐like tyrosine kinase‐1 (sFlt-1) and fetoplacental circulation were assessed at the time of diagnosis. Receiver operating characteristic curves were used to assess the performance of sFlt-1/PlGF for predicting adverse perinatal outcomes (APO). The optimal cut-offs to predict each adverse outcome were calculated and the resulting areas under the curve (AUC) were compared to those calculated from the cut-off points of 38, 85 and 110. The need for delivery at <30 and <34 weeks and APO were the main outcome measures. The optimal cut-off points to predict APO, delivery <30 and <34 weeks were 24.9, 116.7 and 97.5, respectively. None of them proved to be superior to 38, 85 or 110 for predicting any adverse pregnancy outcome. Impact Statement: What is already known on this subject? Soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) are biomarkers of placental dysfunction. High sFlt‐1/PlGF values predict adverse perinatal outcomes in preeclampsia (PE). What do the results of this study add? No specific thresholds have been described to identify early-onset foetal growth restriction (FGR) and small for gestational age (SGA) foetuses at higher risk of adverse outcomes. This study describes these specific cut-offs and compares their predictive capacity to those described for PE. What are the implications of these findings for clinical practice and/or further research? The sFlt-1/PlGF cut-off points of 38, 85 and 110 might be useful for ruling out the occurrence of APO and the need for elective delivery at <30 and at <34 weeks from the moment of diagnosis in early-onset FGR and SGA. These cut-offs could aid Doppler studies in the distinction between FGR and SGA.