Department of Obstetrics and Gynecology, Gachon University of Gil Medical Center, Incheon, South Korea.
J Obstet Gynaecol Res. 2021 Jul;47(7):2318-2323. doi: 10.1111/jog.14815. Epub 2021 May 10.
Preeclampsia is clinically unpredictable and associated with adverse outcomes. Pregnant women with suspected preeclampsia require intensive monitoring or hospitalization for elevated sFlt-1 (soluble fms-like tyrosine kinase-1) to PlGF (placental growth factor) ratios before symptoms arise. We aimed to determine the sFlt-1/PlGF ratio's usefulness in predicting adverse pregnancy outcomes in preeclampsia.
From January 2017 to February 2019, we measured the sFlt-1/PlGF ratio in 73 singleton pregnant women suspected of preeclampsia and classified them into three groups: low-risk (sFlt-1/PlGF ratio < 38, n = 19), intermediate (38 ≤ ratio < 85, n = 9), and high-risk (ratio ≥ 85, n = 32).
Although the low- and high-risk groups both experienced weight gain during pregnancy, their body mass index (BMI) differed after pregnancy (p = 0.004). The number of women who had been taking antihypertensive medications for chronic hypertension since early pregnancy was higher in the low-risk group (31.6% vs. 22.2%, 6.7%). The gestational weeks at birth were lower in the high-risk group compared to that of the low-risk group (32.0 weeks vs. 35.79 weeks, p < 0.001). In the high-risk group, the average neonatal weight was significantly lighter (p = 0.021), and the period of stay in the neonatal intensive care unit was longer than that in the low-risk group (p = 0.003).
The sFlt-1/PlGF ratio is a useful indicator of preeclampsia severity and can be utilized as a prognostic marker.
子痫前期临床表现不可预测,且与不良结局相关。对于疑似子痫前期的孕妇,在出现症状之前,若可溶性 fms 样酪氨酸激酶-1(sFlt-1)与胎盘生长因子(PlGF)比值升高,需要加强监测或住院治疗。本研究旨在探讨 sFlt-1/PlGF 比值在预测子痫前期不良妊娠结局中的作用。
本研究回顾性分析了 2017 年 1 月至 2019 年 2 月期间 73 例疑似子痫前期的单胎妊娠孕妇的 sFlt-1/PlGF 比值,并将其分为低危组(sFlt-1/PlGF 比值<38,n=19)、中危组(38≤比值<85,n=9)和高危组(比值≥85,n=32)。
虽然低危组和高危组孕妇在妊娠期间均有体重增加,但产后体质量指数(BMI)不同(p=0.004)。低危组中有 31.6%(6/19)的孕妇在早孕期就开始服用降压药治疗慢性高血压,高于高危组的 22.2%(7/32)(p=0.006)。高危组孕妇的分娩孕周明显低于低危组(32.0 周 vs. 35.79 周,p<0.001)。高危组新生儿平均体重明显较轻(p=0.021),且在新生儿重症监护病房的停留时间长于低危组(p=0.003)。
sFlt-1/PlGF 比值是子痫前期严重程度的有用指标,可作为预测标志物。