Angiogenic factors for the prediction of preeclampsia in high-risk women.
OBJECTIVE
The objective of the study was to evaluate angiogenic factors for the prediction of preeclampsia in high-risk women.


METHODS
We collected serial serum specimens from 94 women at high preeclampsia risk between 22 and 36 weeks' gestation. Soluble fms-like tyrosine kinase-1 (sFlt1) and placental growth factor (PlGF) were measured by enzyme-linked immunosorbent assay.


RESULTS
Mean serum sFlt1 and the sFlt1/PlGF ratio were higher in subjects who developed early-onset (less than 34 weeks) preeclampsia, as compared with subjects without preeclampsia, from 22 weeks gestation onward. In subjects who developed late-onset (34 weeks or later) preeclampsia, sFlt1 was significantly increased after 31 weeks' gestation. The sFlt1/PlGF ratio at 22-26 weeks was highly predictive of early-onset preeclampsia. The within-woman rate of change of the sFlt1/PlGF ratio was predictive of overall preeclampsia risk.


CONCLUSIONS
In high-risk women, serum sFlt1 and the sFlt1:PlGF ratio are altered prior to preeclampsia onset and may be predictive of preeclampsia. Larger studies are needed to confirm these findings.
Moore Simas
Tiffany A
TA
Department of Obstetrics and Gynecology, University of Massachusetts Medical School/UMass Memorial Health Care, Worcester, MA 01605, USA. mooret@ummhc.org
Crawford
Sybil L
SL
Solitro
Matthew J
MJ
Frost
Sara C
SC
Meyer
Bruce A
BA
Maynard
Sharon E
SE
D000328:Adult; D043925:Angiogenesis Inducing Agents / Q000097:blood; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood*; D018566:Pregnancy, High-Risk / Q000097:blood; D011446:Prospective Studies; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*