BMC Pregnancy Childbirth. 2022 Jun 27;22(1):520. doi: 10.1186/s12884-022-04817-6.
ABSTRACT
OBJECTIVE: To compare the prognostic performance of biomarkers soluble fms-like tyrosine kinase-1 (sFlt-1), Placental Growth Factor (PIGF), and sFlt-1/PIGF ratio as continuous values or as a binary cut-off of 38 for predicting preeclampsia (PE) within 7 days.
DESIGN: Secondary analysis of a randomised clinical trial.
SETTING: Oxford University Hospitals, Oxford, United Kingdom (UK).
POPULATION: Pregnant women between 24+0 to 37+0 weeks of gestation with a clinical suspicion of preeclampsia.
MAIN OUTCOME: Onset of preeclampsia within 7 days of the initial biomarker test.
METHODS: Logistic regression model for onset of preeclampsia using: (i) sFlt-1 (ii) PIGF, (iii) sFlt-1/PIGF ratio (continuous), and (iv) sFlt-1/PIGF ratio as a cut-off above or below 38.
RESULTS: Of the total 370 women, 42 (11.3%) developed PE within 7 days of screening. Models with sFlt-1 and sFlt-1/PIGF ratio (continuous) had greater overall performance than models with PIGF or with sFlt-1/PIGF ratio as a cut-off at 38 (R2: sFlt-1 = 55%, PIGF = 38%, sFlt-1/PIGF ratio = 57%, sFlt-1/PIGF ratio as cut-off at 38 model = 46%). The discrimination performance was the highest in sFlt-1 and sFlt-1/PIGF ratio (continuous) (c-statistic, sFlt-1 = 0.94, sFlt-1/PIGF ratio (continuous) = 0.94) models compared to PIGF or sFlt-1/PIGF cut-off models (c-statistic, PIGF = 0.87, sFlt-1/PIGF cut-off = 0.89).
CONCLUSION: Models using continuous values of sFlt-1 only or sFlt-1/PIGF ratio had better predictive performance compared to a PIGF only or the model with sFlt-1/PIGF ratio as a cut-off at 38. Further studies based on a larger sample size are warranted to substantiate this finding.
PMID:35761268 | DOI:10.1186/s12884-022-04817-6
