Tanaka Hiroaki, Tanaka Kayo, Takakura Sho, Enomoto Naosuke, Ikeda Tomoaki
Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Japan.
Front Med (Lausanne). 2022 Jun 20;9:900639. doi: 10.3389/fmed.2022.900639. eCollection 2022.
The aim of this study was to determine the usefulness of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) in predicting the time for pregnancy termination in pregnant women with known preeclampsia (PE) onset.
Forty-four pregnant women diagnosed with PE (22 weeks 0 days to 33 weeks 6 days gestation) were included in this study. The levels of sFlt-1 and PlGF, and the sFlt-1/PlGF ratio were compared between the women that delivered in <24 h (T group) and those that delivered in more than 24 h (P group), and between women that delivered in <1 week (T group) and those that delivered in more than 1 week (P group). Cutoff values were calculated for the three markers that were the most significantly correlated with predicting pregnancy termination at <24 h and <1 week.
Among sFlt-1, PlGF, and sFlt-1/PlGF, sFlt-1 was the most significantly associated with the timing of pregnancy termination. sFlt-1 cutoff values of 8682.1 pg/ml (AUC 0.71; 95%Cl, 0.5191-0.9052) and 7,394.5 pg/ml (AUC 0.78; 0.78, 95%Cl, 0.6394-0.9206) for delivery in <24 h and delivery within 1 week, respectively, were important predictive values. The positive predictive value for delivery within 24 h was 43.9%, with a sensitivity of 72.3% and specificity of 69.0%, when sFlt-1 was <8,682 pg/ml. A sFlt-1 level of 7,394 pg/ml or greater would result in delivery within 1 week, with a positive predictive value of 67.2%; the sensitivity was 79.0% and specificity was 72.0%.
This study showed that sFlt-1 may be effective in predicting the timing of pregnancy termination. However, the number of cases was small and, thus, the results were not definitive. This finding should be researched further in order to predict the optimal timing of pregnancy termination in PE to reduce severe maternal complications.
本研究的目的是确定胎盘生长因子（PlGF）和可溶性fms样酪氨酸激酶-1（sFlt-1）在预测已知先兆子痫（PE）发作的孕妇终止妊娠时间方面的作用。
本研究纳入了44例诊断为PE的孕妇（妊娠22周0天至33周6天）。比较了在<24小时内分娩的妇女（T组）和在超过24小时内分娩的妇女（P组）之间，以及在<1周内分娩的妇女（T组）和在超过1周内分娩的妇女（P组）之间的sFlt-1和PlGF水平以及sFlt-1/PlGF比值。计算了与预测<24小时和<1周内终止妊娠最显著相关的三个标志物的临界值。
在sFlt-1、PlGF和sFlt-1/PlGF中，sFlt-1与终止妊娠时间的相关性最显著。对于<24小时内分娩和1周内分娩，sFlt-1的临界值分别为8682.1 pg/ml（AUC 0.71；95%Cl，0.5191-0.9052）和7394.5 pg/ml（AUC 0.78；0.78，95%Cl，0.6394-0.9206），是重要的预测值。当sFlt-1<8682 pg/ml时，24小时内分娩的阳性预测值为43.9%，敏感性为72.3%，特异性为69.0%。sFlt-1水平≥7394 pg/ml会导致在1周内分娩，阳性预测值为67.2%；敏感性为79.0%，特异性为72.0%。
本研究表明sFlt-1可能有效地预测终止妊娠的时间。然而，病例数较少，因此结果并不确定。这一发现应进一步研究，以预测PE患者终止妊娠的最佳时间，减少严重的孕产妇并发症。
