title: Onset threshold of the plasma levels of soluble fms-like tyrosine kinase 1/placental growth factor ratio for predicting the imminent onset of preeclampsia within 4 weeks after blood sampling at 19-31 weeks of gestation.
abstract: Our aim was to evaluate the onset threshold of plasma levels of the soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio for predicting the imminent onset of preeclampsia (PE) within 4 weeks after blood sampling. We prospectively measured the plasma levels of sFlt-1 and PlGF by an automated electrochemiluminescence immunoassay at 19-25 weeks of gestation in 1199 women and at 26-31 weeks of gestation in 798 women. The onset threshold of the sFlt-1/PlGF ratio was determined as the 2.5th percentile of the 95th confidence interval (CI) of a regression line between the onset gestational weeks of PE and the standard deviation score of log10(sFlt-1/PlGF), using 25 samples taken within 1 week after the onset of PE. The imminent onset of PE was identified in 2 (0.2%) women recruited at 19-25 weeks and in 6 (0.8%) women recruited at 26-31 weeks. The onset threshold of plasma levels of the sFlt-1/PlGF ratio at 19-25 weeks showed a sensitivity (SE) of 1.00, a specificity (SP) of 1.00, a positive likelihood ratio (LR+) of ∞ and a positive predictive value (PPV) of 1.00; the onset threshold of plasma levels of the sFlt-1/PlGF ratio at 26-31 weeks showed a SE of 0.83, a SP of 0.994, a LR+ of 132 (95% CI: 51-339) and a PPV of 0.50. In conclusion, the onset threshold of plasma levels of the sFlt-1/PlGF ratio was shown to be a highly sensitive and a highly specific screening method for detecting the imminent onset of PE within 4 weeks after blood sampling at 19-31 weeks.
authors: Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Tochigi, Japan.
authors: Akihide
authors: A
authors: Ohkuchi
authors: Chikako
authors: C
authors: Hirashima
authors: Kayo
authors: K
authors: Takahashi
authors: Hirotada
authors: H
authors: Suzuki
authors: Shigeki
authors: S
authors: Matsubara
authors: Mitsuaki
authors: M
authors: Suzuki
mesh_terms: D000328:Adult; D000367:Age Factors; D001794:Blood Pressure / Q000502:physiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007118:Immunoassay; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D018919:Neovascularization, Physiologic; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D011257:Pregnancy Proteins / Q000097:blood*; D011262:Pregnancy Trimester, Second / Q000502:physiology; D011263:Pregnancy Trimester, Third / Q000502:physiology; D012372:ROC Curve; D012016:Reference Values; D055988:Uterine Artery / Q000502:physiology; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*
chemical_list: C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1