Satorres-Pérez Elena, Martínez-Varea Alicia, Novillo-Del Álamo Blanca, Morales-Roselló José, Diago-Almela Vicente
Department of Obstetrics and Gynecology, La Fe University and Polytechnic Hospital, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain.
Department of Pediatrics, Obstetrics and Gynecology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain.
J Clin Med. 2024 May 4;13(9):2699. doi: 10.3390/jcm13092699.
Preterm birth impacts 60% of twin pregnancies, with the subsequent risk of complications in both newborns secondary to the immaturity of organs. This study aims to assess the utility of the sFlt-1/PlGF ratio throughout pregnancy in predicting late preterm birth and adverse perinatal outcomes related to prematurity in twin pregnancies. This is a prospective cohort study developed at a tertiary hospital. All pregnant women with a twin pregnancy who signed the informed consent were included. The sFlt-1/PlGF ratio was measured at 12, 24, and 32 weeks' gestation. Seventy patients were included, from which 54.3% suffered late preterm birth. Results revealed a significant difference in sFlt-1/PlGF ratio at week 32 between term and preterm groups, with a one-unit increase associated with a 1.11-fold increase in the probability of preterm birth. The sFlt-1/PlGF ratio at week 32 alone presented considerable predictive capacities (sensitivity of 71%, specificity of 72%, a PPV of 75%, and an NPV of 68%. Similarly, at week 24, a one-unit increase in sFlt-1/PlGF ratio was associated with a 1.24-fold increase in the probability of adverse perinatal events due to prematurity. Combining parity, maternal age, conception method, BMI, and chorionicity, the model yielded better predictive capacities (sensitivity of 82%, specificity of 80%, PPV of 58%, NPV of 93%). The potential of the sFlt-1/PlGF ratio as a predictive tool for preterm birth and adverse perinatal outcomes secondary to prematurity in twin pregnancies is underscored.
早产影响60%的双胎妊娠，由于器官不成熟，两个新生儿随后都有出现并发症的风险。本研究旨在评估整个孕期sFlt-1/PlGF比值在预测双胎妊娠晚期早产及与早产相关的不良围产期结局中的作用。这是一项在三级医院开展的前瞻性队列研究。纳入了所有签署知情同意书的双胎妊娠孕妇。在妊娠12、24和32周时测量sFlt-1/PlGF比值。共纳入70例患者，其中54.3%发生晚期早产。结果显示，足月组和早产组在32周时sFlt-1/PlGF比值存在显著差异，该比值每增加一个单位，早产概率增加1.11倍。仅32周时的sFlt-1/PlGF比值就具有相当的预测能力（敏感性为71%，特异性为72%，阳性预测值为75%，阴性预测值为68%）。同样，在24周时，sFlt-1/PlGF比值每增加一个单位，因早产导致不良围产期事件的概率增加1.24倍。综合产次、产妇年龄、受孕方式、体重指数和绒毛膜性，该模型具有更好的预测能力（敏感性为82%，特异性为80%，阳性预测值为58%，阴性预测值为93%）。强调了sFlt-1/PlGF比值作为双胎妊娠早产及早产相关不良围产期结局预测工具的潜力。
