Angiogenic and antiangiogenic facors such as sFlt-1 and, respectively, PlGF play a
major role in the pathogenesis of preeclampsia (PE) and can be used clinically as
adjunct tests to diagnose PE in unclear cases. However, it is not known if these markers
can predict the course of PE. For optimal management of patients with PE, such a test
would be clinically useful, e.g. for indication of administration of antenatal glucocorticoids.
The aim of this study was to investigate the correlation between the sFlt-1/PIGF-values
and time to delivery (TTD), being a surrogate marker for the severity of the course
of PE.
Material and methods: In this cohort study 57 patients with overt PE at admission were enrolled at the
University Hospital of Bern between 2011 and 2014. sFlt-1 and PlGF were analysed in
peripheral blood using the ROCHE Elecsys Test. We analysed the correlation between
angiogenic markers and TTD, using TTD as surrogate marker for severe course of PE.
The results of angiogenic factors were not used clinically for indication for delivery.
Results: No significant correlation between these angiogenic markers and TTD was found when
all 57 cases were analysed (sFlt-1: spearman r =-0.16, p = 0.232; PLGF: spearman r
= 0.007, p = 0.957; sFlt-1/PLGF ratio: spearman r =-0.086, p = 0.523). When we sub-stratified
in early-onset PE and late-onset PE, however, we found a significant inverse correlation
in the early-onset PE group (n = 44) for the sFlt-1/PLGF ratio (spearman r =-0.299,
p = 0.048). The sFlt-1/PLGF ratio in patients with delivery prior to 48 H in this
group of 44 patients were higher when compared with patients with delivery > 48 H,
but without significance (< 48 H vs. > 48 H: 373.8 ± 67.31 vs. 362.2 ± 77.94, p =
0.916)
Discussion: In summary our data show that in patients affected by early-onset PE, the sFlt-1/PlGF
ratio correlates inversely with TTD. We therefore propose that sFlt-1/PlGF can be
used clinically to predict the course of the disease in patients with early-onset
PE.
