Short-Term Prediction of Adverse Outcomes Using the sFlt-1 (Soluble fms-Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) Ratio in Asian Women With Suspected Preeclampsia

Xuming Bian, Arijit Biswas, Xianghuang Huang, Kyoung Jin Lee, Thomas Kwok To Li, Hisashi Masuyama, Akihide Ohkuchi, Joong Shin Park, Shigeru Saito, Kok Hian Tan, Tatsuo Yamamoto, Angela Dietl, Sonja Grill, Wilma D.J. Verhagen-Kamerbeek, Jae Yoon Shim, Martin Hund

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Abstract

Current diagnostic criteria have limited clinical value for prediction of preeclampsia and fetal adverse outcomes. The prediction of short-term outcome in pregnant women with suspected preeclampsia study in Asia (PROGNOSIS Asia) was a prospective, multicenter study designed to investigate the value of the sFlt-1 (soluble fms-like tyrosine kinase 1)/PlGF (placental growth factor) ratio for predicting adverse outcomes in pregnant Asian women with suspected preeclampsia. Seven hundred sixty-four pregnant women at gestational week 20+0 days (18+0 days in Japan) to 36+6 days were enrolled at 25 sites in Asia. The primary objectives were to demonstrate the value of the sFlt-1/PlGF ratio for ruling out preeclampsia within 1 week and ruling in preeclampsia within 4 weeks. The value of the ratio for predicting fetal adverse outcomes was also assessed. Seven hundred patients were evaluable for primary end point analysis. The prevalence of preeclampsia was 14.4%. An sFlt-1/PlGF ratio of ≤38 had a negative predictive value of 98.6% (95% CI, 97.2%-99.4%) for ruling out preeclampsia within 1 week, with 76.5% sensitivity and 82.1% specificity. The positive predictive value of a ratio of >38 for ruling in preeclampsia within 4 weeks was 30.3% (95% CI, 23.0%-38.5%), with 62.0% sensitivity and 83.9% specificity. An sFlt-1/PlGF ratio of ≤38 had a negative predictive value of 98.9% (95% CI, 97.6%-99.6%) for ruling out fetal adverse outcomes within 1 week and a ratio of >38 had a positive predictive value of 53.5% (95% CI, 45.0%-61.8%) for ruling in fetal adverse outcomes within 4 weeks. The sFlt-1/PlGF ratio cutoff of 38 demonstrated clinical value for the short-term prediction of preeclampsia in Asian women with suspected preeclampsia, potentially helping to prevent unnecessary hospitalization and intervention.

Original languageEnglish
Pages (from-to)164-172
Number of pages9
JournalHypertension (Dallas, Tex. : 1979)
Volume74
Issue number1
DOIs
Publication statusPublished - Jul 1 2019

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Keywords

  • angiogenic factor
  • Asia
  • fms-like tyrosine kinase
  • placenta growth factor
  • preeclampsia
  • pregnancy outcome
  • prognosis

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Bian, X., Biswas, A., Huang, X., Lee, K. J., Li, T. K. T., Masuyama, H., Ohkuchi, A., Park, J. S., Saito, S., Tan, K. H., Yamamoto, T., Dietl, A., Grill, S., Verhagen-Kamerbeek, W. D. J., Shim, J. Y., & Hund, M. (2019). Short-Term Prediction of Adverse Outcomes Using the sFlt-1 (Soluble fms-Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) Ratio in Asian Women With Suspected Preeclampsia. Hypertension (Dallas, Tex. : 1979), 74(1), 164-172. https://doi.org/10.1161/HYPERTENSIONAHA.119.12760