Neonatal Med.  2023 Aug;30(3):61-68. 10.5385/nm.2023.30.3.61.

Associations between Maternal sFlt-1/PlGF Ratio and Perinatal and Neonatal Outcomes in Newborns Born to Mothers with Preeclampsia

• Yang HJ
• Lim SY
• Kim HS
• Choi CW
• Jung YH

• KMID: 2545426
• DOI: http://doi.org/10.5385/nm.2023.30.3.61

Abstract

Purpose
The ratio of soluble fms-like tyrosine kinase 1 (sFlt-1) to placental growth factor (PlGF) is considered a predictive marker of preeclampsia. However, the relationship between the sFlt-1/PlGF ratio and perinatal and neonatal outcomes remains unknown. This study aimed to determine the associations of the sFlt-1/PlGF ratio with perinatal and neonatal outcomes in newborns born to mothers with preeclampsia.
Methods
This retrospective cohort study reviewed singleton neonates born to mothers with preeclampsia who underwent testing for the sFlt-1/PlGF ratio. We investigated the relationship between maternal sFlt-1/PlGF ratios and gestational age (GA), birth weight (Bwt), Bwt z-score, morbidities, and mortality of neonates born to mothers tested for the sFlt-1/PlGF ratio. Maternal sFlt-1/PlGF ratios examined within 30 days before delivery were used for analysis. Neonatal morbidities and mortality were investigated only in preterm infants born earlier than 32 weeks GA.
Results
A total of 225 neonates were included, of which 163 (72.4%) were preterm infants. GA (R=– 0.577, p<0.001), Bwt (R=–0.713, p<0.001), and Bwt z-score (R=–0.608, p<0.001) exhibited significant negative correlations with the sFlt-1/PlGF ratios. Among the 50 preterm infants born earlier than 32 weeks GA, neonatal morbidities were not significantly associated with the sFlt-1/PlGF ratio after adjusting for GA and Bwt.
Conclusion
In mothers with preeclampsia, a higher sFlt-1/PlGF ratio was associated with the delivery of newborns with lower GA and lower Bwt. However, this ratio was not associated with increased morbidity or mortality in premature infants born earlier than 32 weeks GA.

Keyword

sFlt-1/PlGF ratio; Pre-eclampsia; Premature; Infant; Morbidity

Figure

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  Figure 1. Flow diagram of study population. Abbreviations: PE, preeclampsia; sFlt-1, soluble fms-like tyrosine kinase 1; PlGF, placental growth factor.

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  Figure 2. The correlation between maternal soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio and gestational age. Scatter plot of Spearman's rank correlation coefficient shows a negative correlation between maternal sFlt-1/ PlGF ratio and gestational age.

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  Figure 3. The correlation between maternal soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio and (A) birth weight, (B) birth weight Z-score. Scatter plot of Spearman's rank correlation coefficient shows a negative correlation between maternal sFlt-1/PlGF ratio and (A) birth weight and (B) birth weight Z-score.

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  Figure 4. Receiver operating characteristic (ROC) curve of maternal soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio for preterm birth. The ROC curve analysis of maternal sFlt-1/PlGF ratio was performed to identify an appropriate predictor of preterm birth. The area under the ROC (AUROC) was 0.75.

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