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EP17.17: Plasma sFlt‐1/PlGF ratio as multiples of the median predicts pre‐eclampsia with severe features within two weeks

Year: 2024
Type: conference-abstract
Abstract: To compare multiples of the median (MoM) of maternal plasma sFlt-1/PlGF ratio, sFlt-1, PlGF, and conventional clinical and laboratory values to predict pre-eclampsia with severe features (PSF) within two weeks. Secondary data analysis of a study across 18 US centres involving hospitalised hypertensive individuals between 23-35 weeks of gestation. ROC curve analyses of maternal plasma biomarkers, highest systolic or diastolic blood pressures, and laboratory values at enrolment were performed for the prediction of PSF. Their areas under the curve (AUC) were compared, and quasi-Poisson regression models were fitted to estimate relative risks. The primary outcome was PSF within two weeks. Secondary outcomes were a composite of severe adverse maternal outcomes (HELLP syndrome, placental abruption, eclampsia, DIC, and pulmonary edema), and a composite of severe adverse neonatal outcomes (birthweight <3rd percentile, very preterm birth [<32 weeks] and fetal/neonatal death) within two weeks. PSF within two weeks was observed in 33.2% (180/543). A cut-off of ≥ 11.5 MoM for sFlt-1/PlGF plasma ratio was used to compare cases and controls (< cut-off). PSF within two weeks (66.0% vs. 5.7%; <0.001), and composites of severe adverse maternal (8.11% vs. 2.7%; p = 0.006) or perinatal outcomes (41.3% vs. 10.14%; p = 0.001) were more frequent in cases than controls. This cut-off was independently associated with PSF (adjusted incidence rate ratio [aIRR]: 9.08, 95% CI: 6.11 to 14.06; p < 0.001) and a composite of severe adverse perinatal outcomes (aIRR: 9.42, 95% CI: 6.36 to 14.53; p < 0.001), but not with a composite of severe adverse maternal outcomes (p = 0.08). The AUC of sFlt-1/PlGF plasma ratio in MoM for PSF within two weeks was significantly higher (p < 0.001 for all comparisons) than either plasma biomarker alone or any other parameter. sFlt-1/PlGF plasma ratio ≥11.5 MoM among hospitalised, hypertensive patients between 23-35 weeks of gestation predicts progression to PSF and severe adverse perinatal outcomes within two weeks.
DOI: 10.1002/uog.28674
Authors: J. Espinoza, V. Calsavara, S. Kilpatrick, S. Rana, M. Costantine, K. Boggess, T. Moore Simas, J. Louis, S. Gaw, A. Murtha, S. Wiegand, Y. Gollin, D. Singh, R. Silver, D. Durie, B. Panda, E. Norwitz, I. Burd, B. Plunkett, R. Scott, E. Lemoine, R. Thadhani, A. Karumanchi
Institutions: The University of Texas Health Science Center at Houston, Cedars-Sinai Medical Center, University of Chicago Medical Center, The Ohio State University Wexner Medical Center, The Ohio State University, University of North Carolina at Chapel Hill, UMass Memorial Medical Center, University of South Florida, University of California, San Francisco, Miami Valley Hospital, Sharp Mary Birch Hospital for Women & Newborns, Torrance Memorial Medical Center, University of Utah Hospital, University of Utah Health Care, Lehigh Valley Health Network, Lehigh Valley Hospital, Tufts Medical Center, Newton Wellesley Hospital, Johns Hopkins University, Johns Hopkins Medicine, Endeavor Health, MedStar Health Research Institute, University of North Carolina Wilmington, Emory University
Language: English
Field: Medicine
Open Access status: bronze
Funders: Ohio State University, Emory University, Tufts Medical Center, Johns Hopkins University, University of South Florida, MedStar Health Research Institute, NorthShore University HealthSystem, Cedars-Sinai Medical Center, University of North Carolina Wilmington, University of North Carolina at Chapel Hill
OpenAlex ID: W4402360517
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