VP31.06: Changes in preterm labour and premature birth during the COVID‐19 lockdown: a single‐centre and state comparative analysis in Australia

Abstract

Objectives: To explore the performance of endotheliopathy biomarkers and angiogenic factors in distinguishing pre-eclampsia (PE) from COVID-19 in pregnancy. Methods: Plasma and sera samples were obtained from pregnant women with COVID-19 infection (n= 18) and patients with PE (n = 13). Biomarker assessment included circulating VCAM-1, TNF-receptor I (TNFRI), angiotensin II (ANGII), heparan sulfate (HS), thrombomodulin (TM), C5b9, PAI-1, ADAMTS-13 activity, fms-like tyrosine kinase-1 (sFlt1) and placental growth factor (PlGF). The area under the ROC curve was calculated for each of the biomarkers and for the sFlt1/PlGF ratio. Results: VCAM-1, TNFRI, ANGII, C5b9, sFlt1 and sFlt1/PlGF ratio were significantly higher (p < 0.05) in PE whereas HS and PlGF were significantly lower (p < 0.05) compared to patients with COVID-19. No differences were observed in TM, PAI-1, ADAMTS-13 activity between the study groups. sFlt1/PlGF ratio showed the highest area under the curve (0.96) with a detection rate of 90% for 10% false positive rate (figure 1). PlGF has the lowest area under the curve (0.70) among the studied biomarkers with a detection rate of 0% for 10% false positive rate. Conclusions: PE could be distinguished from COVID-19 by sFlt1/PlGF ratio and other endotheliopathy biomarkers. PlGF should not be used alone in in this context. Instead, the use of sFlt1/PlGF ratio is the best candidate to detect PE and rule out COVID-19.