Prediction of preeclampsia with angiogenic biomarkers. Results from the prospective Odense Child Cohort

ABSTRACT

Objective: We aimed to investigate how maternal serum soluble Fms-like kinase 1 (sFlt-1), placental growth factor (PlGF), and sFlt-1/PlGF ratio prospectively associate to preeclampsia (PE) and clinical subtypes. Methods: In an unselected cohort of 1909 pregnant women, sFlt-1 and PlGF were measured with KRYPTOR assays in gestational weeks (GW) 8–14 and 20–34. Associations to PE were assessed by receiver operating characteristics and logistic regression. Results: Concentrations of sFlt-1, PlGF, and sFlt-1/PlGF in GW20-34 were predictive of PE development, but not in GW8-14. PlGF outperformed sFlt-1/PlGF ratio with an area under curve (AUC) of 0.755 vs. 0.704, p = 0.002. The highest AUC values for PlGF and sFlt-1/PlGF ratio were seen for severe early-onset PE (0.901 and 0.883). Negative predictive values were high for all PE types, but positive predictive values were low. Conclusion: PlGF and sFlt-1/PlGF had good predictive value for PE at GW20-34 in a population-based unselected cohort, however with low positive predictive value.

KEYWORDS:

• PlGF
• prediction
• preeclampsia
• prenatal screening
• sFlt-1

Acknowledgment

sFlt-1 and PlGF were measured in collaboration with BRAHMS GmBH at their facility in Hennigsdorf, Berlin. BRAHMS had no further involvement in collection or interpretation of data, writing of the report, or decision to submit the article for publication.

Declarations of interest

Henrik T. Christesen has received an open research grant from BRAHMS GmbH. Louise B. Andersen, and Henrik T. Christesen have received speaker fees from BRAHMS GmbH. The other authors report no conflicts of interest.

Funding sources

The study was supported by The Region of Southern Denmark, Odense University Hospital. The funding sources had no involvement in collection, analysis and interpretation of data, writing of the report, or decision to submit the article for publication.

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