sFlt-1/PlGF Ratio in Prediction of Short-Term Neonatal Outcome of Small for Gestational Age Neonates

Abstract

Background: Small for gestational age is a pregnancy complication associated with a variety of adverse perinatal outcomes. The aim of the study was to investigate if sFlt-1/PlGF ratio is related to adverse short-term neonatal outcome in neonates small for gestational age in normotensive pregnancy. Methods: A prospective observational study was conducted. Serum sFlt-1/PlGF ratio was measured in women in singleton gestation diagnosed with fetus small for gestational age. Short-term neonatal outcome analyzed in the period between birth and discharge home. Results: Eighty-two women were included. Women with sFlt-1/PlGF ratio ≥33 gave birth to neonates with lower birthweight at lower gestational age. Neonates from high ratio group suffered from respiratory disorders and NEC significantly more often. They were hospitalized at NICU more often and were discharged home significantly later. sFlt-1/PlGF ratio predicted combined neonatal outcome with sensitivity of 73% and specificity of 82.2%. Conclusions: sFlt-1/PlGF ratio is a useful toll in prediction of short-term adverse neonatal outcome in SGA pregnancies.

The sFlt1/PlGF ratio predicts faster fetal deterioration in early fetal growth restriction: A historical cohort study

“…23 In particular, the study from Garcia-Manau et al 27 reports a positive ratio in 21.5% of patients with early FGR in stage I. Quezada et al, 26 however, in a cohort of early FGR pregnancies, reported an even higher rate (75% positive sFlt1/PlGF ratios), with a mean ratio value of 196 (whereas in our cohort, mean sFlt1/PlGF was 91.2). We hypothesize that our population is more similar to the stage I population described in the former study by Garcia-Manau et al 27 Looking at the correlation between sFlt1/PlGF ratio and latency to delivery/fetal demise, it was clear that a higher ratio predicts a faster fetal deterioration and an earlier delivery/fetal demise for early FGR fetuses, even after excluding deliveries for maternal indications and controlling for confounders (occurrence and S3). When considering the cut-off described in the literature for ratio positivity, a positive ratio significantly correlates with an earlier delivery/fetal demise and shorter latency to delivery/fetal demise (Table S2).…”

“…Mean gestational age at diagnosis of FGR in our cohort (27.2 gestational weeks) was similar to previous reports. 26,27 In agreement with TA B L E 1 Description of the study population (early FGR pregnancies) regarding maternal, pregnancy, delivery and newborn characteristics.…”

“…In addition, an increased sFlt1/PlGF ratio has been shown to correlate with adverse outcomes in early FGR 22,23 and to predict shorter intervals to delivery in patients with preeclampsia or FGR 24 . Other studies have shown that higher sFlt1/PlGF ratios predict a shorter interval to delivery in early FGR 25–27 . However, those studies did not control for the occurrence of preeclampsia and thus it is not clear whether this correlation is due to the known association between preeclampsia and FGR, or whether the sFlt1/PlGF ratio can predict fetal clinical deterioration even in the absence of this complication.…”

The Impact of Increased Maternal sFlt-1/PlGF Ratio on Motor Outcome of Preterm Infants

“…Chang et al have already shown that infants with a high maternal sFlt-1/PlGF ratio above 85 had a lower birth weight (1142 ± 472 g vs. 2311 ± 236 g, p<0.001) and a higher risk for prematurity, BPD and respiratory distress syndrome (RDS) compared to the low ratio group (13). Also, Witwicki et al demonstrated that children of women with a sFlt-1/PlGF ratio ≥33 were significantly smaller, had more respiratory and gastrointestinal morbidity, and longer hospitalization (44). A relationship between a high ratio and low birth weight was also shown in our study.…”

“…Also, Witwicki et al. demonstrated that children of women with a sFlt-1/PlGF ratio ≥33 were significantly smaller, had more respiratory and gastrointestinal morbidity, and longer hospitalization ( 44 ). A relationship between a high ratio and low birth weight was also shown in our study.…”