Predictive Performance of sFlt-1, PlGF and the sFlt-1/PlGF Ratio for Preeclampsia: A Systematic Review and Meta-Analysis

Abstract

Background: It is difficult to evaluate whether monitoring serum sFlt-1, PlGF, or sFlt-1/PlGF in pregnant women who are suspected of having PE can significantly shorten the PE diagnosis time. Objectives: To estimate the accuracy of sFlt-1, PlGF and sFlt-1/PlGF in preeclampsia prediction. Search Strategy: Databases including PubMed, Web of Science, Medline, CNKI, SinoMed, VIP Journal, and Wanfang Data were searched for eligible studies published until October 7, 2020. Selection Criteria: The research subjects were pregnant women with or without PE. The research types were case-control studies and cohort studies. This was an original study involving the detection of at least one of the following in the blood, serum or plasma: sFlt-1, PlGF, and sFlt-1/PlGF. Data Collection and Analysis: Meta-Disc 1.4 was employed, using the Sen, Spe, PLR, NLR, and DOR to plot SROC, and subgroup analysis and meta-regression were conducted. Main Results: Meta-analysis showed that for sFlt, PlGF and sFlt-1/PlGF, the Sen was 0.811 (95% CI: 0.783-0.837), 0.735 (95% CI: 0.713–0.757), and 0.779 (95% CI: 0.763–0.795), respectively; the Spe was 0.786 (95% CI: 0.769-0.802), 0.731 (95% CI: 0.721-0.741),and 0.885 (95% CI: 0.881-0.889), respectively. Conclusions: The sFlt-1/PlGF ratio showed better predictive performance for preeclampsia than sFlt-1 or PlGF alone. However, the predictive value of the latter two cannot be ignored. Funding: Xinjiang Uygur Autonomous Region “Tianshan Innovation Team Plan”(2020D14010) Keywords: gestational hypertension; hypertension; meta-analysis; preeclampsia; predictive; PlGF; sFlt-1; sFlt-1/ PlGF, systematic review