Department of Obstetrics and Gynecology, Medical University Vienna, Vienna, Austria; the Department of Obstetrics, Maternal-Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, and the Maternal and Child Health and Development Network (SAMID) RD12/0026, Instituto de Salud Carlos III, Barcelona, Spain; the Department of Obstetrics and Gynecology, University of Liege, CHR de la Citadelle, Liege, Belgium; Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom (previously University Hospitals National Health Service Trust, Coventry, United Kingdom, during the conduct of the study); the Departments of Gynecology and Obstetrics, Oslo University Hospital and University of Oslo, Oslo, Norway; the Department of Women's and Children's Health, Karolinska University Hospital, Karolinska Institute, Stockholm, and the Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; the Pregnancy Research Centre, Department of Maternal-Fetal Medicine, Royal Women's Hospital and Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia; the Department of Obstetrics, University of Leipzig, Leipzig, Roche Diagnostics GmbH, Penzberg, and the Department of Obstetrics, Charité Universitätsmedizin, Berlin, Germany; and Roche Diagnostics International, Rotkreuz, Switzerland.
Obstet Gynecol. 2016 Aug;128(2):261-269. doi: 10.1097/AOG.0000000000001525.
To assess the association of a serum soluble fms-like tyrosine kinase 1-to-placental growth factor (sFlt-1-to-PlGF) ratio of greater than 38 with time to delivery and preterm birth.
Secondary analysis of an observational cohort study that included women 18 years of age or older from 24 to 36 6/7 weeks of gestation at their first study visit with suspected (not confirmed) preeclampsia. Participants were recruited from December 2010 to January 2014 at 30 sites in 14 countries. A total of 1,041 women were included in time-to-delivery analysis and 848 in preterm birth analysis.
Women with an sFlt-1-to-PlGF ratio greater than 38 (n=250) had a 2.9-fold greater likelihood of imminent delivery (ie, delivery on the day of the test) (Cox regression hazard ratio 2.9; P<.001) and shorter remaining time to delivery (median 17 [interquartile range 10-26] compared with 51 [interquartile range 30-75] days, respectively; Weibull regression factor 0.62; P<.001) than women with an sFlt-1-to-PlGF ratio of 38 or less, whether or not they developed preeclampsia. For women who did not (n=842) and did develop preeclampsia (n=199), significant correlations were seen between an sFlt-1-to-PlGF ratio greater than 38 and preterm birth (r=0.44 and r=0.46; both P<.001). Among women who did not develop preeclampsia, those who underwent iatrogenic preterm delivery had higher median sFlt-1-to-PlGF ratios at their first visit (35.3, interquartile range 6.8-104.0) than those who did not (8.4, interquartile range 3.4-30.6) or who delivered at term (4.3, interquartile range 2.4-10.9).
In women undergoing evaluation for suspected preeclampsia, a serum sFlt-1-to-PlGF ratio greater than 38 is associated with a shorter remaining pregnancy duration and a higher risk of preterm delivery.
评估血清可溶性 fms 样酪氨酸激酶 1 与胎盘生长因子（sFlt-1 与 PlGF）比值大于 38 与分娩时间和早产的关系。
这是一项观察性队列研究的二次分析，纳入了年龄在 18 岁及以上、首次就诊时妊娠 24 至 36+6/7 周且疑似（未经证实）子痫前期的女性。参与者于 2010 年 12 月至 2014 年 1 月在 14 个国家的 30 个地点招募。共有 1041 名女性纳入分娩时间分析，848 名女性纳入早产分析。
sFlt-1 与 PlGF 比值大于 38 的女性（n=250）即刻分娩（即当天分娩）的可能性增加 2.9 倍（Cox 回归风险比 2.9；P<.001），且剩余分娩时间更短（中位数 17[四分位距 10-26]与 51[四分位距 30-75]天，分别；Weibull 回归因子 0.62；P<.001），而比值为 38 或更低的女性无论是否发生子痫前期，即刻分娩的可能性或剩余分娩时间更短。对于未发生子痫前期的女性（n=842）和发生子痫前期的女性（n=199），sFlt-1 与 PlGF 比值大于 38 与早产之间存在显著相关性（r=0.44 和 r=0.46；均 P<.001）。在未发生子痫前期的女性中，行医源性早产的女性首次就诊时的 sFlt-1 与 PlGF 比值中位数较高（35.3，四分位距 6.8-104.0），而未行医源性早产的女性（8.4，四分位距 3.4-30.6）或足月分娩的女性（4.3，四分位距 2.4-10.9）较低。
在接受疑似子痫前期评估的女性中，血清 sFlt-1 与 PlGF 比值大于 38 与妊娠剩余时间较短和早产风险增加相关。
