Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia.

Zeisler, H; Llurba, E; Chantraine, F; Vatish, M; Staff, A; Sennström, M; Olovsson, M; Brennecke, S; Stepan, H; Allegranza, D; Dilba, P; Schoedl, M; Hund, M; Verlohren, S

Women's Health Collection

Journal article

Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia.

Abstract:: Background
The ratio of soluble fms-like tyrosine kinase 1 (sFlt-1) to placental growth factor (PlGF) is elevated in pregnant women before the clinical onset of preeclampsia, but its predictive value in women with suspected preeclampsia is unclear.
Methods
We performed a prospective, multicenter, observational study to derive and validate a ratio of serum sFlt-1 to PlGF that would be predictive of the absence or presence of preeclampsia in the short term in women with singleton pregnancies in whom preeclampsia was suspected (24 weeks 0 days to 36 weeks 6 days of gestation). Primary objectives were to assess whether low sFlt-1:PlGF ratios (at or below a derived cutoff) predict the absence of preeclampsia within 1 week after the first visit and whether high ratios (above the cutoff) predict the presence of preeclampsia within 4 weeks.
Results
In the development cohort (500 women), we identified an sFlt-1:PlGF ratio cutoff of 38 as having important predictive value. In a subsequent validation study among an additional 550 women, an sFlt-1:PlGF ratio of 38 or lower had a negative predictive value (i.e., no preeclampsia in the subsequent week) of 99.3% (95% confidence interval [CI], 97.9 to 99.9), with 80.0% sensitivity (95% CI, 51.9 to 95.7) and 78.3% specificity (95% CI, 74.6 to 81.7). The positive predictive value of an sFlt-1:PlGF ratio above 38 for a diagnosis of preeclampsia within 4 weeks was 36.7% (95% CI, 28.4 to 45.7), with 66.2% sensitivity (95% CI, 54.0 to 77.0) and 83.1% specificity (95% CI, 79.4 to 86.3).
Conclusions
An sFlt-1:PlGF ratio of 38 or lower can be used to predict the short-term absence of preeclampsia in women in whom the syndrome is suspected clinically. (Funded by Roche Diagnostics.)

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Zeisler, H., Llurba, E., Chantraine, F., Vatish, M., Staff, A., Sennström, M., Olovsson, M., Brennecke, S., Stepan, H., Allegranza, D., Dilba, P., Schoedl, M., Hund, M., & Verlohren, S. (2016). Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia. New England Journal of Medicine, 374(1), 13–22.

MLA Style

Zeisler, H, et al. “Predictive Value of the SFlt-1:PlGF Ratio in Women with Suspected Preeclampsia.” New England Journal of Medicine, vol. 374, no. 1, 2016, pp. 13–22.

Chicago Style

Zeisler, H, E Llurba, F Chantraine, et al. 2016. “Predictive Value of the SFlt-1:PlGF Ratio in Women with Suspected Preeclampsia.” New England Journal of Medicine 374 (1): 13–22.
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