Reproduction, Mother and Child Health Unit, CHU de Québec - Université Laval Research Center, Université Laval, Québec City, QC; Department of Social and Preventive Medicine, Université Laval, Québec City, QC.
Reproduction, Mother and Child Health Unit, CHU de Québec - Université Laval Research Center, Université Laval, Québec City, QC; Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU de Toulouse, Université de Toulouse, Toulouse, France.
J Obstet Gynaecol Can. 2020 Oct;42(10):1235-1242. doi: 10.1016/j.jogc.2020.03.024. Epub 2020 Apr 28.
Preeclampsia is associated with a higher maternal blood levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and lower levels of placental growth factor (PlGF) that appear before clinical onset. We aimed to estimate the normal progression of these biomarkers in normal pregnancies and in those affected by preeclampsia.
We conducted a case-cohort study including low-risk nulliparous women recruited at 11-13 weeks gestation (cohort) and women with preeclampsia (cases). Maternal blood was collected at different points during pregnancy including at the time of diagnosis of preeclampsia for cases. Maternal serum PlGF and sFlt-1 concentrations and the sFlt-1/PlGF ratio were measured using B•R•A•H•M•S plus KRYPTOR automated assays and were compared between patients in both groups matched for gestational age. Cases were stratified as early- (≤34 weeks), intermediate- (35-37 weeks) and late-onset (>37 weeks) preeclampsia.
The cohort consisted of 45 women whose results were compared with those of 31 women who developed preeclampsia, diagnosed at a median gestational age of 32 weeks (range 25-38 weeks). We observed that sFlt-1, PlGF and their ratio fluctuated during pregnancy in both groups, with a significant correlation with gestational age after 28 weeks (P < 0.05). We observed a significant difference between cases and controls, with a median ratio 100 times higher in early preeclampsia (P < 0.001), 13 times higher in intermediate preeclampsia (P < 0.001), but no significant difference between groups in late-onset preeclampsia with matched controls.
PlGF, sFlt-1, and their ratio may be useful in the prediction and diagnosis of early- and intermediate-onset preeclampsia but are not useful for late-onset preeclampsia.
子痫前期与可溶性 fms 样酪氨酸激酶-1（sFlt-1）的母体血水平升高和胎盘生长因子（PlGF）水平降低有关，这些变化在临床发病前出现。我们旨在评估这些生物标志物在正常妊娠和子痫前期患者中的正常进展情况。
我们进行了一项病例对照研究，纳入了 11-13 周妊娠的低危初产妇（队列）和子痫前期患者（病例）。在不同时间点采集孕妇血液，包括子痫前期患者的诊断时间。使用 B•R•A•H•M•S plus KRYPTOR 自动化检测系统测量母体血清 PlGF 和 sFlt-1 浓度以及 sFlt-1/PlGF 比值，并在两组患者中进行比较，按孕龄匹配。病例分为早发型（≤34 周）、中发型（35-37 周）和晚发型（>37 周）子痫前期。
该队列包括 45 名女性，将其结果与 31 名在中位孕龄 32 周（25-38 周）时诊断为子痫前期的女性进行比较。我们观察到，sFlt-1、PlGF 及其比值在两组妊娠期间均有波动，在 28 周后与孕龄呈显著相关性（P<0.05）。我们观察到病例组与对照组之间存在显著差异，早发型子痫前期的中位数比值高 100 倍（P<0.001），中发型子痫前期高 13 倍（P<0.001），但在匹配对照组的晚发型子痫前期中两组间无显著差异。
PlGF、sFlt-1 及其比值可用于预测和诊断早发型和中发型子痫前期，但对晚发型子痫前期无预测价值。
