Journal
BMC PREGNANCY AND CHILDBIRTH
Volume 13, Issue -, Pages -Publisher
BMC
DOI: 10.1186/1471-2393-13-110
Keywords
Preeclampsia; Prediction; Vasoactive agents; Placental growth factor; Soluble fms-like tyrosine kinase-1
Categories
Funding
- Roche Diagnostics Inc, Finland (Elecsys assays)
- Academy of Finland
- Clinical Graduate School in Paediatrics and Obstetrics/Gynaecology
- University of Helsinki
- Finnish Medical Society Duodecim
- Emil Aaltonen Foundation
- Finnish Concordia Fund
- Finnish Foundation For Paediatric Research
- Finnish Medical Foundation
- Signe and Ane Gyllenberg Foundation
- Sigrid Juselius Foundation
- Government Special Subsidy for Health Sciences at Helsinki and Uusimaa Hospital District
- Jane and Aatos Erkko Foundation
- Orion Foundation
- Paivikki and Sakari Sohlberg Foundation
- Yrjo Jahnsson Foundation
- Novo Nordisk Fonden [NNF12OC1016374] Funding Source: researchfish
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Background: To evaluate the soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and sFlt-1/PlGF ratio for the prediction of early-and late-onset preeclampsia in a high-risk cohort. Methods: We studied serial serum samples collected prospectively at 12 + 0 - 14 + 0, 18 + 0 - 20 + 0, and 26 + 0 - 28 + 0 weeks + days of gestation in 6 women who developed early-onset preeclampsia (before 34 weeks of gestation) and in 21 women who developed late-onset preeclampsia (after 34 weeks of gestation) with automated ElecSys 2010 immunoanalyzer (Roche Diagnostics, Germany). Twenty-six high-risk women and 53 women without risk factors with normal pregnancies served as controls. Results: Serum PlGF concentrations were lower at 18 + 0 to 20 + 0, and 26 + 0 to 28 + 0 weeks of gestation in women who developed early-onset preeclampsia compared to women who developed late-onset preeclampsia and to controls (p < 0.05 for all comparisons). At 18 + 0 to 20 + 0 weeks of gestation area under the receiver-operating characteristic curve (AUC) for serum PlGF was 99.8% (p = 0.0007, 95% CI 99.0-100.0). At 26 + 0 to 28 + 0 weeks of gestation serum sFlt-1/PlGF ratio explicitly detects those women who developed early-onset preeclampsia (AUC 100.0%, p = 0.0007, 95% CI 100-100). Amongst women with late-onset preeclampsia, those who developed severe form of the disease (N = 8) had significantly higher serum sFlt-1 concentrations at all three timepoints (p = 0.004, p = 0.006, and p = 0.003, respectively) compared to women with non-severe form (N = 13). Conclusions: Low serum PlGF concentration predicts early-onset preeclampsia from the second trimester and elevated serum sFlt-1/PlGF ratio from 26 to 28 weeks of gestation. Elevated serum sFlt-1 concentration in the first trimester in women who later develop late-onset, severe preeclampsia may suggest different etiology compared to the late-onset non-severe form of the disease.
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