title: PP051. Prediction of preeclampsia with the sFlt-1/PLGF ratio: impact of the slope of repeated measurements.
abstract: BACKGROUND
  Patients with preeclampsia (PE) exhibit different serum concentrations of sFlt-1 and PlGF. The sFlt-1/PlGF ratio can be used as an aid in the diagnosis of preeclampsia.
  
  
  OBJECTIVE
  The objective of this study was to explore the use of the sFlt-1/PlGF ratio as an aid in the prediction of preeclampsia in women with a high risk of the condition.
  
  
  METHODS
  150 patients with high risk of preeclampsia were included in this prospective study. Groups were compared according to the outcome of pregnancy: healthy pregnant women (controls, n=114), pregnancies complicated by intrauterine growth restriction without PE (IUGR, n=14), early PE<34 weeks of gestation (early PE, n=6) and late PE⩾34 weeks of gestation (late PE, n=16). Measurements of sFlt-1 and PlGF were performed on the automated Elecsys system. Statistical comparison of the sFlt-1/PlGF ratio in different outcome groups and multilevel analysis for logistic data using the random slope model was performed.
  
  
  RESULTS
  We found significant differences in the sFlt-1/PlGF ratio between the outcome groups in weeks 24-36 of gestation (p=0,05). A significant difference in the sFlt-1/PlGF ratio between controls, IUGR and PE (early and late PE) could be measured up to six weeks before diagnosis (PE) or birth (IUGR, controls) (p=0,05). The random slope model showed significant different slopes (p=0,05) for individual outcome groups (controls 0,657; IUGR 1,786; early PE 1,951; late PE 0,881).
  
  
  CONCLUSIONS
  The sFlt-1/PlGF ratio is able to identify pathologic pregnancy outcomes in gestational weeks 24-36. Prediction is feasible up to six weeks before clinical diagnosis (PE) or 6 weeks before birth (IUGR, controls). Repeated measurements are necessary beginning in 24 weeks of gestation with a maximum distance of six weeks. The slope between two measurements of the sFlt-1/PlGF ratio is predictive of further pregnancy outcome and the risk of developing preeclampsia.
authors.affiliation: Klinik für Geburtsmedizin, Charité-Universitätsmedizin Berlin, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Schoofs
authors.affiliation: Klinik für Geburtsmedizin, Charité-Universitätsmedizin Berlin, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Engels
authors.affiliation: Klinik für Gynäkologie und Geburtshilfe, DRK Kliniken Berlin Westend, Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Pape
authors.affiliation: Klinik für Geburtsmedizin, Charité-Universitätsmedizin Berlin, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Henrich
authors.affiliation: Klinik für Geburtsmedizin, Universitätsfrauenklinik Leipzig, Leipzig, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Stepan
authors.affiliation: Klinik für Geburtsmedizin, Charité-Universitätsmedizin Berlin, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Verlohren