Predictive value of sFlt-1, PlGF, sFlt-1/PlGF ratio and PAPP-A for late-onset preeclampsia and IUGR between 32 and 37 weeks of pregnancy
Predictive value of sFlt-1, PlGF, sFlt-1/PlGF ratio and PAPP-A for late-onset preeclampsia and IUGR between 32 and 37 weeks of pregnancy
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DOI：
10.1016/j.preghy.2018.04.010
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发表时间：
2018-04-01
影响因子：
2.2
通讯作者：
Gellhaus, A.
中科院分区：
文献类型：
--
作者：
Birdir, C.;Droste, L.;Gellhaus, A.
目的：探讨妊娠晚期孕妇血清sFlt-1、PlGF和PAPP-A水平与晚发性PE和妊娠34周后胎儿宫内生长迟缓(IUGR)的关系。方法：采用前瞻性研究方法，测定妊娠32~37周孕妇血清可溶性酪氨酸激酶-1(sFlt-1)、胎盘生长因子(PlGF)和妊娠相关血浆蛋白-A(PAPP-A)水平：730例患者中676例无宫内生长受限(IUGR)、子痫前期(PE)或妊娠高血压综合征(PIH)。结果：校正孕妇年龄、采血时胎龄和孕妇BMI后，PE与血清sFlt-1水平(Exp(Beta)=3.29；95%CI：2.69~4.04)、PlGF水平(Exp(Beta)=0.18；95%CI：0.13~0.24)、sFlt-1/PlGF比值(Exp(Beta)=15.59；95%CI：10.64~22.84)和血清PAPP-A(Exp(Beta)=1.48；95%CI：1.15~1.89)。SFlt-1、PlGF和sFlt-1/PlGF比值具有可比的曲线下面积(AUC)估计值，可用于区分妊娠合并PE和IUGR与对照组。PAPP-A对PE的预测能力仅略好于Chance。结论：本研究支持在妊娠晚期单项测定sFlt-1/PlGF比值预测妊娠34周后PE和IUGR的能力。然而，需要更大规模的多中心研究来复制我们的结果。
Objectives: The aim of this study was to investigate, whether maternal serum levels of sFlt-1, PlGF and PAPP-A at third trimester of pregnancy are associated with late-onset PE and intrauterine growth retardation (IUGR) after 34 weeks of pregnancy.Methods: This was a prospective study measuring the maternal serum levels of soluble tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) at 32-37 weeks of pregnancy: 730 patients were enrolled and 676 had neither intrauterine growth restriction (IUGR) nor preeclampsia (PE) or pregnancy induced hypertension (PIH) throughout the pregnancy. 22 patients developed IUGR, 32 PE and 24 PIH.Results: Linear regression analyses after adjusting for maternal age, gestational age at the blood sampling and maternal BMI showed associations between PE and serum sFlt-1 levels (Exp(beta) = 3.29; 95% CI: 2.69-4.04), serum PlGF levels (Exp(beta) = 0.18; 95% CI: 0.13-0.24), sFlt-1/PlGF ratio (Exp(beta) = 15.59; 95% CI: 10.64-22.84) and serum PAPP-A (Exp(beta) = 1.48; 95% CI 1.15-1.89). sFlt-1, PlGF and sFlt-1/PlGF-Ratio showed comparable area under the curve (AUC) estimates with a predictive ability to discriminate pregnancies developing PE and IUGR from controls. The predictive ability of PAPP-A for PE was only slightly better than chance.Conclusions: This study supported the ability of a single measurement of sFlt-1/PlGF ratio at third trimester to predict PE and IUGR occurring after 34 weeks of pregnancy. However, larger multicentre studies are needed to replicate our results.