Antenatal corticosteroid prophylaxis in women with increased sFlt-1/PlGF ratio in the clinical routine – A retrospective analysis
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: The sFlt-1/PlGF ratio is a predictive biomarker for preeclampsia (PE)-related outcomes. In women with signs of PE at ≤34 weeks, it may guide the timing of antenatal corticosteroid (ACS) administration. METHODS: We retrospectively analyzed 702 women presenting with signs of PE and/or fetal growth restriction (FGR) between 22+0- and 33+6-weeks. High risk was defined as an sFlt-1/PlGF ratio ≥85. The predictive accuracy of the ratio for PE-related preterm birth at ≤34+0 weeks was assessed using receiver operating characteristic (ROC) analysis. Differences in remaining pregnancy duration and gestational age at delivery between risk groups were analyzed using the log-rank test (p<0.05). RESULTS: Among 702 patients, 165 (23.5 %) had a PE-related delivery ≤34+0 weeks. A high sFlt-1/PlGF ratio (≥85) was observed in 128 (18.2 %) women who received ACS and in 44 (6.3 %) who didn't. The sFlt-1/PlGF ratio predicted PE-related delivery at ≤34+0 weeks - and thus the need for ACS with an AUC of 0.95 (95 % CI 0.93-0.97), yielding an optimal cut-off of 52.5 with sensitivity 87.9 % (95 % CI 82.0-92.0) and specificity 87.9 % (95 % CI 84.9-90.4). The median remaining pregnancy duration was 7.0 days (IQR 3.0-17.8), with delivery at 29+5 weeks (IQR 26+6-32+0) in women with ACS and a ratio ≥85, vs. 60.0 days (IQR 42.0-80.0) and delivery at 38+1 weeks (IQR 37+0-39+3) in women with a ratio <85 and no ACS. CONCLUSIONS: In women with signs of PE and FGR <34 weeks of gestation, the sFlt-1/PlGF ratio is a strong predictor of PE-related preterm delivery and may support clinical decision-making regarding timely ACS administration.
Source: Journal of Perinatal Medicine
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7124167706