Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia.
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.We performed a prospective, multicenter, observational study to...
| Autori principali: | , , , , , , , , , , , , , |
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| Natura: | Journal article |
| Lingua: | English |
| Pubblicazione: |
2016
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| _version_ | 1826302448785948672 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Zeisler, H |
| collection | OXFORD |
| description | 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.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.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).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.). |
| first_indexed | 2024-03-07T05:47:42Z |
| format | Journal article |
| id | oxford-uuid:e7c3887e-56c0-4bb0-abb2-df076c50d41b |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T05:47:42Z |
| publishDate | 2016 |
| record_format | dspace |
| spelling | oxford-uuid:e7c3887e-56c0-4bb0-abb2-df076c50d41b2022-03-27T10:41:32ZPredictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e7c3887e-56c0-4bb0-abb2-df076c50d41bEnglishSymplectic Elements at Oxford2016Zeisler, HLlurba, EChantraine, FVatish, MStaff, ASennström, MOlovsson, MBrennecke, SStepan, HAllegranza, DDilba, PSchoedl, MHund, MVerlohren, SThe 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.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.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).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.). |
| spellingShingle | 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 Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia. |
| title | Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia. |
| title_full | Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia. |
| title_fullStr | Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia. |
| title_full_unstemmed | Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia. |
| title_short | Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia. |
| title_sort | predictive value of the sflt 1 plgf ratio in women with suspected preeclampsia |
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