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Soluble fms-like tyrosine kinase-1, placental growth factor and their ratio as a predictor for pre-eclampsia in East Asians

•sFlt-1, PlGF and its ratio has a quadratic relationship in normal pregnancies.•The ratio can be used in East Asians presenting with hypertension after 20 weeks.•76% of women at presentation with pre-eclampsia had a sFlt-1 to PlGF ratio ≥38.•Correcting sFLt-1 and PlGF levels for gestation and weight...

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Bibliographic Details
Published in:Pregnancy hypertension 2018-01, Vol.11, p.61-65
Main Authors: Cheng, Yvonne Kwun Yue, Law, Lai Wa, Leung, Tak Yeung, Chan, Oi Ka, Sahota, Daljit Singh
Format: Article
Language:English
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Summary:•sFlt-1, PlGF and its ratio has a quadratic relationship in normal pregnancies.•The ratio can be used in East Asians presenting with hypertension after 20 weeks.•76% of women at presentation with pre-eclampsia had a sFlt-1 to PlGF ratio ≥38.•Correcting sFLt-1 and PlGF levels for gestation and weight improved clinical utility. To assess the clinical utility of the sFlt-1:PlGF ratio rule-in/rule-out pre-eclampsia either directly or after correcting each marker for gestation and maternal weight. This was a prospective cohort study. sFlt-1, PlGF were measured in 965 women randomized to undergo a single blood withdraw between 20 and 39 weeks of gestation. sFlt-1, PlGF and the sFlt-1:PlGF ratio temporal relationship was determined. sFlt-1 and PlGF were converted to multiples of the expected gestational median (MoM) and adjusted for maternal weight. The 90th centile of the adjusted sFlt-1MoM:PlGFMoM ratio was determined. Clinical utility of the sFlt-1:PlGF ratio (≥38) to rule in/rule–out pre-eclampsia (PE) after 20 weeks of gestation versus that of the sFlt-1MoM:PlGFMoM 90th percentile was assessed in 81 women admitted for management of antenatal hypertension. The sFlt-1:PlGF ratio had quadratic relationship with gestation whereas the sFlt-1MoM:PlGFMoM ratio log distribution that was Gaussian with a mean of zero and a standard deviation of 0.85 with a 90th percentile equal to 1.08. Thirty-four (42%) of the 81 women admitted for management of their antenatal hypertension had PE, 26 (76.4%) had a sFlt-1:PlGF ratio ≥ 38. Four of the remaining 8 PE affected pregnancies with sFlt-1:PlGF ratio
ISSN:2210-7789
2210-7797
DOI:10.1016/j.preghy.2017.12.002