Assessing the Prognostic Value of Serum PLGF, sFlt-1, and sFlt-1/PLGF Ratios in Predicting Adverse Pregnancy Outcomes in Preeclampsia: A Comprehensive Analysis

Abstract

Objective: This study investigates the correlation between serum levels of placental growth factor (PLGF), soluble FMS-like tyrosine kinase-1 (sFlt-1), and the sFlt-1/PLGF ratio, and adverse pregnancy outcomes in preeclampsia (PE) patients. Methods: We analyzed data from 1,383 pregnant women diagnosed with preeclampsia at Xi'an People's Hospital (No. 4 Hospital of Xi'an) from July 2022 to June 2023. The participants were categorized into a PE group of 95 individuals, further divided into 53 with mild preeclampsia (mPE) and 42 with severe preeclampsia (sPE), and a control group of 1,288 individuals. The PE group was also subdivided based on pregnancy outcomes into a poor outcome subgroup (367 cases) and a normal delivery subgroup (1,015 cases). Serum PLGF, sFlt-1, and sFlt-1/PLGF levels were measured and analyzed in relation to pregnancy outcomes. Results: The PE group exhibited significantly lower PLGF levels and higher sFlt-1 and sFlt-1/PLGF levels compared to the control group. Within the PE group, the sPE subgroup had significantly lower PLGF and higher sFlt-1/PLGF levels than the mPE subgroup. Patients with adverse outcomes showed significantly higher sFlt-1 and sFlt-1/PLGF levels compared to those with normal delivery outcomes. Spearman correlation analysis indicated a negative correlation between PLGF levels and adverse pregnancy outcomes (ρ = -0.057, P < 0.05), and a positive correlation of sFlt-1 and sFlt-1/PLGF levels with adverse outcomes (ρ = 0.075 and 0.082, respectively; both P < 0.01). Conclusion: Lower serum PLGF and higher sFlt-1 and sFlt-1/PLGF levels are significantly associated with PE and adverse pregnancy outcomes, underscoring their potential as biomarkers for predicting pregnancy complications in PE patients.