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The predictive value of the sFlt‐1/PlGF ratio in suspected preeclampsia in a New Zealand population: A prospective cohort study.
- Source :
-
Australian & New Zealand Journal of Obstetrics & Gynaecology . Feb2023, Vol. 63 Issue 1, p34-41. 8p. - Publication Year :
- 2023
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Abstract
- Background: Internationally, placental growth factor (PlGF)‐based tests are used as prognostic markers in suspected preeclampsia. However, Ministry of Health guidelines do not currently endorse PlGF‐based tests in New Zealand (NZ). Aims: To investigate the predictive value of soluble fms‐like tyrosine kinase 1 (sFlt‐1)/PlGF ratio in suspected preeclampsia in a NZ population. Materials and Methods: A prospective cohort study of singleton pregnancies at 20+0–36+6 weeks gestation with suspected preeclampsia as defined by Society of Obstetric Medicine Australia and NZ (SOMANZ) criteria. Primary objective: to evaluate a sFlt‐1/PlGF ratio >38 at ≤35+0 weeks gestation to predict birth ≤14 days. Secondary objectives: to assess a sFlt‐1/PlGF ratio cut‐off of 38 at ≤37+0 weeks gestation, to rule out preeclampsia ≤1 week, rule in preeclampsia ≤4 weeks, and to predict perinatal outcome. Clinicians were blinded to sFlt‐1/PlGF ratio results. Results: Included were 222 participants, 19.4% Māori and 10.4% Pasifika. A sFlt‐1/PlGF >38 predicted birth ≤14 days, positive predictive value (PPV) 51.4% (95% CI, 39.6–63.0) and negative predictive value (NPV) 95.9% (95% CI, 91.4–98.1), median (interquartile range) days to birth 14 (2–27) vs 49 (33–70), P < 0.000. A sFlt‐1/PlGF cut‐off of 38 ruled out preeclampsia ≤1 week (NPV 96.2% (95% CI, 92.3–98.2)) and ruled in preeclampsia ≤4 weeks (PPV 75.0% (95% CI, 65.0–82.9)). A sFlt‐1/PlGF >38 was associated with greater perinatal morbidity. Conclusions: The predictive value of the sFlt‐1/PlGF ratio in NZ is comparable to that reported in international trials. Used in clinical practice the sFlt‐1/PlGF ratio may aid risk stratification in suspected preeclampsia, directing limited resources to those pregnancies at highest risk. [ABSTRACT FROM AUTHOR]
- Subjects :
- *RISK factors of preeclampsia
*PLACENTAL growth factor
*CHILDBIRTH
*MAGNESIUM sulfate
*LENGTH of stay in hospitals
*STATISTICS
*PREDICTIVE tests
*PREMATURE infants
*INTRAVENOUS therapy
*NEONATAL intensive care
*STROKE
*CONFIDENCE intervals
*ABRUPTIO placentae
*CELL receptors
*GESTATIONAL age
*NEONATAL intensive care units
*PATIENTS
*FETAL growth retardation
*FISHER exact test
*MANN Whitney U Test
*RISK assessment
*PREGNANCY outcomes
*HOSPITAL admission & discharge
*COMPARATIVE studies
*T-test (Statistics)
*PULMONARY edema
*DESCRIPTIVE statistics
*CHI-squared test
*KAPLAN-Meier estimator
*CESAREAN section
*MATERNAL mortality
*INFANT mortality
*DATA analysis
*SMOKING
*RECEIVER operating characteristic curves
*SENSITIVITY & specificity (Statistics)
*BLOOD testing
*LONGITUDINAL method
*SMALL for gestational age
*BLOOD
*EVALUATION
*PREGNANCY
Subjects
Details
- Language :
- English
- ISSN :
- 00048666
- Volume :
- 63
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Australian & New Zealand Journal of Obstetrics & Gynaecology
- Publication Type :
- Academic Journal
- Accession number :
- 161897472
- Full Text :
- https://doi.org/10.1111/ajo.13549