Maternal serum soluble fms‐like tyrosine kinase‐1 at 22 and 32 weeks in the prediction of pre‐eclampsia

Wright, David; Krajewska, Karolina; Bogdanova, Anna; Wright, Alan; Nicolaides, Kypros H.

doi:10.1002/uog.15850

Cited by 8 publications

(10 citation statements)

References 28 publications

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“…For both MAP and PlGF, there was substantially more separation at 30–34 weeks than at 11–13 or 19–24 weeks and there was little benefit of combining the measurements at 30–34 weeks with those taken at earlier gestational ages. As reported in previous studies, sFlt‐1 had very little separation at 11–13 or 19–24 weeks, but, at 30–34 weeks, the separation was larger than that for any other marker; inclusion of the measurements at 19–24 weeks increased the separation substantially.…”

Section: Resultssupporting

confidence: 80%

“…The relationship between MoM values of UtA‐PI, MAP and PlGF at 19–24 weeks and 30–34 weeks in unaffected pregnancies and pregnancies that developed PE and delivered after the third‐trimester assessment but < 37 weeks' gestation are shown in Figure ; the values are compared to those of sFlt‐1 that were reported in a previous study. In the case of UtA‐PI, MAP and PlGF, combined screening at both 19–24 and 30–34 weeks has no or only marginal benefit over screening at 30–34 weeks alone.…”

Section: Resultsmentioning

confidence: 93%

“…In the case of UtA‐PI, MAP and PlGF, combined screening at both 19–24 and 30–34 weeks has no or only marginal benefit over screening at 30–34 weeks alone. In contrast, screening by sFlt‐1 at 30–34 weeks is substantially improved by the addition of data from 19–24 weeks.…”

Section: Resultsmentioning

confidence: 99%

“…Relationship between multiples of the median (MoM) values of: (a) mean arterial pressure (MAP); (b) uterine artery pulsatility index (UtA‐PI); (c) placental growth factor (PlGF); and (d) soluble fms‐like tyrosine kinase‐1 (sFlt‐1) at 19–24 weeks and 30–34 weeks in unaffected pregnancies () and pregnancies that developed pre‐eclampsia and delivered after the third‐trimester assessment and < 37 weeks' gestation (). For UtA‐PI, MAP and sFlt‐1, dashed vertical and horizontal lines represent 90 th percentile of unaffected pregnancies for the biomarker at 19–24 weeks and at 30–34 weeks, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Routine screening for PE by maternal serum sFlt‐1 at 30–34 weeks' gestation can identify most pregnancies that will develop preterm PE and many of those that will develop term PE. We have shown recently that, although serum sFlt‐1 at 19–24 weeks is not a useful marker for PE developing after 32 weeks, the performance of screening for PE by serum sFlt‐1 at 30–34 weeks was improved by inclusion of measurements in the second trimester. In both unaffected pregnancies and those that develop PE, there is a high correlation between second‐ and early third‐trimester measurements of serum sFlt‐1.…”

Section: Introductionmentioning

confidence: 99%

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Repeat measurements of uterine artery pulsatility index, mean arterial pressure and serum placental growth factor at 12, 22 and 32 weeks in prediction of pre‐eclampsia

Andrietti

Carlucci

Wright

et al. 2017

Ultrasound in Obstet & Gyne

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Section: Resultssupporting

confidence: 80%

Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Repeat measurements of uterine artery pulsatility index, mean arterial pressure and serum placental growth factor at 12, 22 and 32 weeks in prediction of pre‐eclampsia

Andrietti

Carlucci

Wright

et al. 2017

Ultrasound in Obstet & Gyne

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The potential of repeated mean arterial pressure measurements for predicting early‐ and late‐onset pre‐eclampsia in twin pregnancies: Prediction model study

He,

Xie,

Guo

et al. 2024

Intl J Gynecology & Obste

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ObjectiveTo investigate the contribution of longitudinal mean arterial pressure (MAP) measurement during the first, second, and third trimesters of twin pregnancies to the prediction of pre‐eclampsia.MethodsA retrospective cohort study was conducted on women with twin pregnancies. Historical data between 2019 and 2021 were analyzed, including maternal characteristics and mean artery pressure measurements were obtained at 11–13, 22–24, and 28–33 weeks of gestation. The outcome measures included pre‐eclampsia with delivery <34 and ≥34 weeks of gestation. Models were developed using logistic regression, and predictive performance was evaluated using the area under the curve, detection rate at a given false‐positive rate of 10%, and calibration plots. Internal validation was conducted via bootstrapping.ResultsA total of 943 twin pregnancies, including 36 (3.82%) women who experienced early‐onset pre‐eclampsia and 93 (9.86%) who developed late‐onset pre‐eclampsia, were included in this study. To forecast pre‐eclampsia during the third trimester, the most accurate prediction for early‐onset pre‐eclampsia resulted from a combination of maternal factors and MAP measured during this trimester. The optimal predictive model for late‐onset pre‐eclampsia includes maternal factors and MAP data collected during the second and third trimesters. The areas under the curve were 0.937 (95% confidence interval [CI] 0.894–0.981) and 0.887 (95% CI 0.852–0.921), respectively. The corresponding detection rates were 83.33% (95% CI 66.53%–93.04%) for early‐onset pre‐eclampsia and 68.82% (95% CI 58.26%–77.80%) for late‐onset pre‐eclampsia.ConclusionRepeated measurements of MAP during pregnancy significantly improved the accuracy of late‐onset pre‐eclampsia prediction in twin pregnancies. The integration of longitudinal data into pre‐eclampsia screening may be an effective and valuable strategy.

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Longitudinal assessment of angiogenic markers in prediction of adverse outcome in women with confirmed pre‐eclampsia

Binder

Palmrich

Kalafat

et al. 2023

Ultrasound in Obstet & Gyne

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ObjectivesAngiogenic marker assessment such as the ratio of soluble fms‐like tyrosine kinase 1 (sFlt‐1) to placental growth factor (PlGF), is known to be a useful tool in the prediction of pre‐eclampsia. However, evidence on surveillance strategies in pregnancies with pre‐eclampsia diagnosis is lacking. Therefore, we aimed to assess the predictive performance of longitudinal maternal serum angiogenic marker assessment for adverse maternal and perinatal outcomes compared to standard laboratory parameters in pregnancies with confirmed pre‐eclampsia.MethodsThis was a retrospective analysis of prospectively collected data from January 2013 to December 2020 at the Medical University of Vienna. The inclusion criteria were singleton pregnancies with confirmed pre‐eclampsia and post‐diagnosis maternal serum angiogenic marker assessment in at least two time points. The primary outcome was the predictive performance of longitudinal sFlt‐1 and PlGF assessment for adverse maternal and perinatal outcomes compared to longitudinal conventional laboratory monitoring measured at the same time as the angiogenic markers in pregnancies with confirmed pre‐eclampsia. Composite maternal adverse outcomes included intensive care unit (ICU) admission, pulmonary edema, eclampsia, and death. Composite adverse perinatal outcomes included stillbirth, neonatal death, placental abruption, neonatal intensive care unit (NICU) admission, intraventricular hemorrhage, necrotizing enterocolitis, respiratory distress syndrome, and mechanical ventilator support.ResultsIn total 885 post‐diagnosis sFlt‐1/PlGF ratio measurements were taken from 323 pregnant women with confirmed pre‐eclampsia. For composite maternal adverse outcome, the highest stand‐alone predictive accuracy was obtained using maternal serum sFlt‐1/PlGF ratio (AUROC 0.72, 95% CI 0.62–0.81), creatinine (AUROC 0.71, 95% CI 0.62–0.81), and lactate dehydrogenase (LDH) levels (AUROC 0.73, 95% CI 0.65–0.81). Maternal platelet levels (AUROC 0.65, 95% CI 0.55–0.74), serum alanine transaminase (ALT) (AUROC 0.59, 95% CI 0.49–0.69) and aspartate aminotransferase (AST) (AUROC 0.61, 95% CI 0.51–0.71) levels had poor stand‐alone predictive accuracy. The best prediction model consisted of a combination of maternal serum LDH, creatinine levels and sFlt‐1/PlGF ratio, which had an AUROC of 0.77 (95% CI 0.68–0.85), significantly higher than sFlt‐1/PlGF ratio alone (P=0.037). For composite perinatal adverse outcome, the highest stand‐alone predictive accuracy was obtained using maternal serum sFlt‐1/PlGF ratio (AUROC 0.82, 95% CI 0.75–0.89) and creatinine (AUROC 0.74, 95% CI 0.67–0.80) levels, while sFlt‐1/PlGF ratio was superior to creatinine alone (P<0.001). Maternal serum LDH levels (AUROC 0.65, 95% CI 0.53–0.74), platelet count (AUROC 0.57, 95% CI 0.44–0.67), ALT (AUROC 0.58, 95% CI 0.48–0.67) and AST (AUROC 0.58, 95% CI 0.48–0.67) levels had poor stand‐alone predictive accuracy. No combination of biomarkers was superior to maternal serum sFlt‐1/PlGF ratio alone for composite perinatal adverse outcome (P>0.05 for all).ConclusionsLongitudinal maternal serum angiogenic marker assessment is a good predictor of adverse maternal and perinatal outcomes and superior to some of the conventional laboratory parameters in pregnancies with pre‐eclampsia. More studies should focus on the optimal surveillance following the diagnosis of pre‐eclampsia.This article is protected by copyright. All rights reserved.

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Maternal serum soluble fms‐like tyrosine kinase‐1 at 22 and 32 weeks in the prediction of pre‐eclampsia

Abstract: ABSTRACT

Cited by 8 publications

References 28 publications

Repeat measurements of uterine artery pulsatility index, mean arterial pressure and serum placental growth factor at 12, 22 and 32 weeks in prediction of pre‐eclampsia

Repeat measurements of uterine artery pulsatility index, mean arterial pressure and serum placental growth factor at 12, 22 and 32 weeks in prediction of pre‐eclampsia

The potential of repeated mean arterial pressure measurements for predicting early‐ and late‐onset pre‐eclampsia in twin pregnancies: Prediction model study

Longitudinal assessment of angiogenic markers in prediction of adverse outcome in women with confirmed pre‐eclampsia

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