Angiogenic Biomarkers: Are They Good Tools to Predict Perinatal Outcomes in Hypertensive Disorders of Pregnancy? A Retrospective Cohort Study

<b>Background</b>: The sFlt-1/PlGF ratio has proven predictive value in diagnosing preeclampsia. Referring to a study from 18 American perinatal centers, we present results from 2 European centers showing the significant value of those markers in predicting severe perinatal outcomes in h...

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Main Authors: Magdalena Bednarek-Jędrzejek, Katarzyna Maksym, Stepan Feduniw, Slagjana Simeonova Krstevska, Igor Samardziski, Tomasz Góra, Michał Ciebiera, Adrianna Zahorowska, Katarzyna Pruś, Sylwia Dzidek, Hanna Jasiak-Jóźwik, Martyna Drzycimska, Ewa Kwiatkowska, Andrzej Torbé, Sebastian Kwiatkowski
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/7/799
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Summary:<b>Background</b>: The sFlt-1/PlGF ratio has proven predictive value in diagnosing preeclampsia. Referring to a study from 18 American perinatal centers, we present results from 2 European centers showing the significant value of those markers in predicting severe perinatal outcomes in hypertensive disorders of pregnancy. <b>Methods</b>: A total of 1630 patients with suspected or confirmed placental insufficiency, hospitalized in two tertiary perinatal centers in Poland and Macedonia, were assessed for their sFlt-1/PlGF ratio. Due to incomplete data, perinatal outcomes were only obtained for 1196 patients. They were sorted into two groups according to the value of the sFlt-1/PlGF ratio (<40 and ≥40). The aim of this study was to predict adverse perinatal outcomes in terms of days to delivery, gestational age, birth weight, and cord blood pH. <b>Results</b>: The strongest negative correlation was observed between the index values and the number of days until delivery (R = −0.48; <i>p</i> < 0.001). In a group of patients with an index value of ≥40, the AUC was 0.9955 (95% CI: 0.9913 to 0.9996), with a sensitivity of 52%, a specificity of 78%, a positive predictive value of 77%, and a negative predictive value of 53%. For patients who were tested before 37 weeks of gestation, 66% of women with a ratio of ≥40 delivered within 7 days of the test, and 80% of those with a ratio of <40 delivered more than 7 days after the test, with a sensitivity of 68%, a specificity of 79%, a positive predictive value of 66%, and a negative predictive value of 80%. <b>Conclusions</b>: In women with hypertensive disorders, the sFlt-1/PlGF ratio can be used to predict the time to delivery. A cut-off of 40 is very useful in predicting severe perinatal outcomes.
ISSN:2075-4418