期刊
PREGNANCY HYPERTENSION-AN INTERNATIONAL JOURNAL OF WOMENS CARDIOVASCULAR HEALTH
卷 3, 期 4, 页码 215-221出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.preghy.2013.04.119
关键词
Fms-like tyrosine kinase-1; Placental growth factor; First trimester; Pregnancy hypertension; Pre-eclampsia; Predictive accuracy
资金
- National Health and Medical Research Council (NHMRC) [632653]
- Centre for Research Excellence Grant [1001066]
- NHMRC [1021025, 632955]
Objective: To assess the accuracy of first trimester soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) in predicting pregnancy hypertension and pre-eclampsia; and compare with the accuracy of routinely collected maternal and clinical risk factors. Study design: In this population-based cohort study, serum sFlt-1 and PlGF levels were measured in first trimester in 2,681 women with singleton pregnancies in New South Wales, Australia. Main outcome measures: Prediction of pregnancy hypertension and pre-eclampsia. Results: There were 213 (7.9%) women with pregnancy hypertension, including 68 (2.5%) with pre-eclampsia. The area under the curve (AUC) for both sFlt-1 and PlGF was not different from chance, but combined was 0.55 (P = 0.005). Parity and previous diagnosed hypertension had better predictive accuracy than serum biomarkers (AUC = 0.64, P < 0.001) and the predictive accuracy for all maternal and clinical information was fair (AUC = 0.70, P < 0.001 for pregnancy hypertension and AUC = 0.74, P < 0.001 for pre-eclampsia). Adding sFlt-1 and PlGF to maternal risk factors did not improve the ability of the models to predict pregnancy hypertension or pre-eclampsia. Conclusions: Maternal first trimester serum concentrations of sFlt-1 and PlGF do not predict hypertensive disorders in pregnancy any better than routinely collected clinical and maternal risk factor information. Screening for sFlt-1 and PlGF levels in early pregnancy would not identify those pregnancies at-risk. (C) 2013 The Authors. Published by Elsevier B.V. on behalf of International Society for the Study of Hypertension in Pregnancy.
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