Chang Yu-Shan, Chen Chi-Nien, Jeng Suh-Fang, Su Yi-Ning, Chen Chien-Yi, Chou Hung-Chieh, Tsao Po-Nien, Hsieh Wu-Shiun
Department of Pediatrics, National Taiwan University Children's Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Department of Pediatrics, National Taiwan University Hsinchu Branch, Hsinchu, Taiwan.
Pediatr Neonatol. 2017 Dec;58(6):529-533. doi: 10.1016/j.pedneo.2016.10.005. Epub 2017 May 10.
Soluble fms-like tyrosine kinase receptor-1 (sFlt-1)/placental growth factor (PlGF) ratio has been studied extensively as a predictive marker for pre-eclampsia. However, its usefulness for predicting neonatal outcomes remains unknown. This study aimed to evaluate the association of sFlt-1/PlGF ratio with pregnancy outcomes, neonatal morbidities and short-term postnatal growth patterns in pregnant women and their babies.
sFlt-1 and PlGF were measured in women with fetal intrauterine growth retardation (IUGR) or pre-eclampsia during gestational age (GA) of 16-36 weeks. These women were classified into high- and low-ratio groups with a sFlt-1/PlGF cut-off ratio of 85. The maternal and neonatal outcomes were retrospectively reviewed and compared between the two groups.
A total of 25 pregnant women were recruited. Thirteen of them had a sFlt-1/PlGF ratio over 85 and twelve had a ratio of less than 85. The median duration from elevation of sFlt-1/PlGF to delivery was 4.5 weeks. Women in the high SFlt-1/PlGF ratio group had higher rates of intrauterine fetal demise (2/13 vs. 0/12) and early termination (1/13 vs. 0/12). The surviving offspring in this group had a higher incidence of preterm birth (GA: 31.4 ± 2.9 weeks vs. 37.3 ± 1.3 weeks, p < 0.001), lower birth weight (1142 ± 472 g vs. 2311 ± 236 g, p < 0.001), higher incidence of respiratory distress syndrome (6/10 vs. 0/12, p = 0.002) and bronchopulmonary dysplasia (4/10 vs. 0/12, p = 0.01). However, the percentile of body weight, height and head circumference at 28 days of age, 56 days of age and the corrected age of 6 months were comparable between groups.
High sFlt-1/PlGF ratio in pregnant women is associated with poor pregnancy and neonatal outcomes. Therefore, the monitoring of sFlt-1/PlGF ratio in pregnant women with fetal IUGR and timely management for placenta-associated diseases are recommended.
可溶性fms样酪氨酸激酶受体-1（sFlt-1）/胎盘生长因子（PlGF）比值作为子痫前期的预测标志物已得到广泛研究。然而，其对预测新生儿结局的作用尚不清楚。本研究旨在评估sFlt-1/PlGF比值与孕妇及其婴儿的妊娠结局、新生儿发病率和产后短期生长模式之间的关联。
在孕16 - 36周时，对患有胎儿宫内生长受限（IUGR）或子痫前期的孕妇测定sFlt-1和PlGF。这些孕妇被分为高比值组和低比值组，sFlt-1/PlGF截断比值为85。对两组孕妇的母婴结局进行回顾性分析并比较。
共招募了25名孕妇。其中13名孕妇的sFlt-1/PlGF比值超过85，12名孕妇的比值低于85。sFlt-1/PlGF升高至分娩的中位时间为4.5周。高sFlt-1/PlGF比值组的孕妇胎儿宫内死亡（2/13 vs. 0/12）和早产（1/13 vs. 0/12）发生率较高。该组存活后代的早产发生率更高（孕周：31.4 ± 2.9周 vs. 37.3 ± 1.3周，p < 0.001），出生体重更低（1142 ± 472 g vs. 2311 ± 236 g，p < 0.001），呼吸窘迫综合征（6/10 vs. 0/12，p = 0.002）和支气管肺发育不良（4/10 vs. 0/12，p = 0.01）的发生率更高。然而，两组在出生后28天、56天和矫正年龄6个月时的体重、身高和头围百分位数相当。
孕妇高sFlt-1/PlGF比值与不良妊娠和新生儿结局相关。因此，建议对患有胎儿IUGR的孕妇监测sFlt-1/PlGF比值，并及时处理胎盘相关疾病。
