Prediction of Adverse Pregnancy Outcome Related to Placental Dysfunction Using the sFlt-1/PlGF Ratio: A Narrative Review

Graupner, O; Enzensberger, C

doi:10.1055/a-1403-2576

Cited by 5 publications

(4 citation statements)

References 49 publications

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“…As obesity is an epidemic disease affecting more and more pregnancies, outcome prediction in this subgroup is of urgent need. Outcome prediction in pre-eclamptic women using (anti-)angiogenic factors, especially sFlt-1/PIGF, was evaluated over the last decade [ 16 , 19 , 34 ]. In our study cohort, sFlt-1/PIGF had a high prognostic value for APO, a finding in line with previous publications of our working group [ 20 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Performance of sFlt-1/PIGF Ratio for the Prediction of Perinatal Outcome in Obese Pre-Eclamptic Women

Karge

Desing

Haller

et al. 2022

JCM

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Obese women are at high risk of developing pre-eclampsia (PE). As an altered angiogenic profile is characteristic for PE, measurement of soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PIGF) ratio in the maternal serum can be helpful for PE diagnosis, as well as for adverse perinatal outcome (APO) prediction. There is growing evidence that obesity might influence the level of sFlt-1/PIGF and, therefore, the aim of the study was the evaluation of sFlt-1/PIGF as an APO predictor in obese women with PE. Pre-eclamptic women who had an sFlt-1/PIGF measurement at the time of diagnosis were retrospectively included. Women were classified according to their pre-pregnancy body mass index (BMI) as normal weight (BMI < 25 kg/m2), overweight (BMI > 25–29.9 kg/m2) or obese (BMI ≥ 30 kg/m2). APO was defined as the occurrence of one of the following outcomes: Small for gestational age, defined as a birthweight < 3rd centile, neonatal mortality, neonatal seizures, admission to neonatal unit required (NICU) or respiratory support. A total of 141 women were included. Of them, 28 (20%) patients were obese. ROC (receiver operating characteristic) analysis revealed a high predictive value for sFlt-1/PIGF and APO across the whole study cohort (AUC = 0.880, 95% CI: 0.826–0.936; p < 0.001). However, the subgroup of obese women showed a significantly lower level of sFlt-1 and, therefore, the performance of sFlt-1/PIGF as APO predictor was poorer compared to normal or overweight PE women (AUC = 0.754, 95% CI: 0.552–0.956, p = 0.025). In contrast to normal or overweight women, a ratio of sFlt-1/PIGF < 38 could not rule out APO in women with obesity.

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Section: Discussionmentioning

confidence: 99%

Performance of sFlt-1/PIGF Ratio for the Prediction of Perinatal Outcome in Obese Pre-Eclamptic Women

Karge

Desing

Haller

et al. 2022

JCM

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“…Die vorliegenden Ergebnisse zur fetomaternalen Doppler-Sonografie im Low-Risk-Kollektiv (AGA-Feten) werfen die Frage auf, ob aufgrund der Assoziation mit einem APO insbesondere in der Terminüberschreitung eine klinische Konsequenz aus auffälligen [49]. Erste Arbeiten zum Stellenwert (anti-)angiogener Faktoren im unselektierten und Low-Risk-Kollektiv in Terminnähe zeigen ein Potenzial der plazentaren Biomarker, wenn es um die APO-Prädiktion geht.…”

Section: Fetomaternale Doppler-sonografieunclassified

“…However, none of the randomized-controlled trials addressing the question of predicting (and improving) perinatal outcomes have to date evaluated the sFlt-1/PlGF ratio in pregnancies with PD (PE, FGR). The increasing tendency to use placental biomarkers to predict an APO in the PD population is reflected in recent work that observed an association between greatly elevated sFlt-1/PlGF levels (> 655 in < 34 + 0 WG, > 201 in ≥ 34 + 0 WG) and an APO or a shortened time interval till delivery due to perinatal complications 49 .…”

Section: Biomarkers – (Anti-)angiogenic Factorsmentioning

confidence: 99%

“…Die zunehmende Tendenz, plazentare Biomarker im PD-Kollektiv für die APO-Prädiktion zu verwenden, zeigt sich in aktuellen Arbeiten, die eine Korrelation aus stark erhöhten sFlt-1/PlGF-Werten (> 655 in < 34 + 0 SSW, > 201 in ≥ 34 + 0 SSW) und einem APO bzw. verkürzten Zeitintervall bis zur Entbindung aufgrund von perinatalen Komplikationen beobachten konnten 49 .…”

Section: Biomarker – (Anti-)angiogene Faktorenunclassified

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New Markers for Placental Dysfunction at Term – Potential for More

Graupner

Kuschel

Axt-Fliedner

et al. 2022

Geburtshilfe Frauenheilkd

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The remaining placental reserve capacity at term plays a decisive role in the perinatal morbidity of mother and child. Considering advances made in the field of fetal monitoring, the routine examination methods currently used at term or late term may be insufficient to detect subclinical placental dysfunction (PD). The aim of this study is to offer an up-to-date, narrative review of the literature in the context of detecting PD at term using complementary ultrasound markers and biomarkers. Parameters of fetomaternal Doppler ultrasound and fetal cardiac function, as well as (anti-)angiogenic factors in maternal serum are potential PD markers. These may help identify patients that may benefit from an elective, early induction of labor at term, thereby potentially reducing morbidity and mortality. However, their value in terms of the optimal date of delivery must first be determined in randomized controlled trials on a large number of cases.

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