The feasibility of soluble Fms-Like Tyrosine kinase-1 (sFLT-1) and Placental Growth Factor (PlGF) ratio biomarker in predicting preeclampsia and adverse pregnancy outcomes among medium to high risk mothers in Kuala Lumpur, Malaysia

• Published in: PloS one 2022-03, Vol.17 (3), p.e0265080-e0265080
• Main Authors: Aminuddin, Nurul Afzan, Sutan, Rosnah, Mahdy, Zaleha Abdullah, Rahman, Rahana Abd, Nasuruddin, Dian Nasriana
• Format: Article
• Language: English
• Subjects: Algorithms; Apgar score; Biology and Life Sciences; Biomarkers; Birth weight; Blood pressure; Complications; Feasibility Studies; Female; Growth factors; Gynecology; Health risks; Heart failure; Hematology; Humans; Hypertension; Immunoassay; Intubation; Kinases; Laboratories; Low birth weight; Malaysia - epidemiology; Male; Maternal mortality; Medicine; Medicine and Health Sciences; Morbidity; Mothers; Obstetrics; Placenta; Placenta Growth Factor - blood; Pre-eclampsia; Pre-Eclampsia - diagnosis; Pre-Eclampsia - epidemiology; Predictions; Predictive Value of Tests; Preeclampsia; Pregnancy; Pregnancy Outcome; Prospective Studies; Protein-tyrosine kinase; Risk; Sensitivity analysis; Tertiary; Tyrosine; Urban areas; Urban environments; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factor Receptor-1 - blood; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0265080

Preeclampsia significantly contributes to maternal and perinatal morbidity and mortality. It is imperative to identify women at risk of developing preeclampsia in the effort to prevent adverse pregnancy outcomes through early intervention. Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) level changes are noticeable several weeks before the onset of preeclampsia and its related complications. This study evaluated the feasibility of the sFlt-1/PlGF biomarker ratio in predicting preeclampsia and adverse pregnancy outcomes using a single cut-off point of >38. This is a prospective cohort study conducted at a single tertiary centre, in an urban setting in Kuala Lumpur, Malaysia, between December 2019 and April 2021. A total of 140 medium to high risk mothers with singleton pregnancies were recruited at ≥20 weeks' gestation. sFlt-1/PlGF ratio was measured and the participant monitored according to a research algorithm until delivery. The primary outcome measure was incidence of preeclampsia and the secondary outcome measure was incidence of other adverse pregnancy outcomes. The overall incidence of preeclampsia was 20.7% (29/140). The mean sFlt-1/PlGF ratio was significantly higher in preeclampsia (73.58 ± 93.49) compared to no preeclampsia (13.41 ± 21.63) (p = 0.002). The risk of preeclampsia (adjusted OR 28.996; 95% CI 7.920-106.164; p38 compared with sFLT-1/PlGF ratio ≤38. The area under the receiver-operator characteristic curve (AUC) for a combined approach (maternal clinical characteristics and biomarker) was 86.9% (p