Pregnancy Research Centre, Department of Maternal-Fetal Medicine, Royal Women's Hospital, Parkville, Victoria, Australia; The University of Melbourne, Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Parkville, Victoria, Australia.
Pauline Gandel Imaging Centre, Royal Women's Hospital, Parkville, Victoria, Australia; Monash Ultrasound for Women, Clayton, Victoria, Australia.
Pregnancy Hypertens. 2019 Apr;16:112-119. doi: 10.1016/j.preghy.2019.03.009. Epub 2019 Mar 21.
Pre-eclampsia remains a significant cause of morbidity and mortality. Placental biomarkers soluble Fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) have been investigated previously for their ability to predict pre-eclampsia. We compared the performance of these biomarkers for midpregnancy pre-eclampsia prediction using three different immunoassay platforms.
Prospective study including singleton pregnancies 19-22 weeks' gestation. Maternal bloods were collected at recruitment. Screening performances using receiver operating characteristic (ROC) curves for PlGF and sFlt-1/PlGF ratio raw data and MoM values in isolation were evaluated for three immunoassay platforms using selected cut-off values.
Pre-eclampsia was defined as early-onset (<34 weeks' at delivery) and preterm (<37 weeks' at delivery).
For prediction of preterm pre-eclampsia, PlGF MoM and sFlt-1/PlGF ratio MoM performed similarly, with areas under the curve (AUC), detection rates (DR) and false positive rates (FPR) for PlGF MoM and sFlt-1/PlGF ratio MoM being 0.77-0.79 and 0.71-0.74, 62.5% for both and 9.7-14.9 and 10.7-17.7, respectively. For the prediction of early-onset pre-eclampsia, sFlt-1/PlGF ratio raw data and MoM values performed similarly, with AUC, DR and FPR being 0.92-0.97 and 0.93-0.96, 100% for both, and 4.13-16.9 and 9.4-12.2, respectively.
For midpregnancy prediction of preterm pre-eclampsia, PlGF MoM for all three platforms and sFlt-1/PlGF ratio MoM for the two platforms that tested sFlt-1 performed similarly. For midpregnancy prediction of early-onset pre-eclampsia at midpregnancy, sFlt-1/PlGF ratio raw data and MoM values using the early-onset cut-off for the two platforms that tested sFlt-1 gave similar performance from a clinical perspective.
子痫前期仍然是发病率和死亡率的重要原因。可溶性 Fms 样酪氨酸激酶-1（sFlt-1）和胎盘生长因子（PlGF）等胎盘生物标志物已被用于预测子痫前期的能力。我们比较了使用三种不同免疫分析平台的这些生物标志物在中期妊娠子痫前期预测中的表现。
前瞻性研究包括 19-22 周妊娠的单胎妊娠。在招募时采集孕妇血液。使用接受者操作特征（ROC）曲线评估 PlGF 和 sFlt-1/PlGF 比值原始数据以及单独使用 MoM 值的筛查性能，使用选定的截止值评估三种免疫分析平台。
子痫前期定义为早发（分娩前<34 周）和早产（分娩前<37 周）。
对于预测早产子痫前期，PlGF MoM 和 sFlt-1/PlGF 比值 MoM 的表现相似，曲线下面积（AUC）、检出率（DR）和假阳性率（FPR）分别为 0.77-0.79 和 0.71-0.74，均为 62.5%和 9.7-14.9 和 10.7-17.7，分别为 10.7-17.7。对于早发子痫前期的预测，sFlt-1/PlGF 比值原始数据和 MoM 值的表现相似，AUC、DR 和 FPR 分别为 0.92-0.97 和 0.93-0.96，均为 100%，和 4.13-16.9 和 9.4-12.2，分别为 9.4-12.2。
对于中期妊娠早产子痫前期的预测，所有三种平台的 PlGF MoM 和测试 sFlt-1 的两种平台的 sFlt-1/PlGF 比值 MoM 表现相似。对于中期妊娠早发子痫前期的预测，使用测试 sFlt-1 的两种平台的早发截止值的 sFlt-1/PlGF 比值原始数据和 MoM 值在临床角度上具有相似的性能。
