title: Soluble fms-Like Tyrosine Kinase-1-to-Placental Growth Factor Ratio and Time to Delivery in Women With Suspected Preeclampsia.
abstract: To assess the association of a serum soluble fms-like tyrosine kinase 1-to-placental growth factor (sFlt-1-to-PlGF) ratio of greater than 38 with time to delivery and preterm birth.
  
  
  
  Secondary analysis of an observational cohort study that included women 18 years of age or older from 24 to 36 6/7 weeks of gestation at their first study visit with suspected (not confirmed) preeclampsia. Participants were recruited from December 2010 to January 2014 at 30 sites in 14 countries. A total of 1,041 women were included in time-to-delivery analysis and 848 in preterm birth analysis.
  
  
  
  Women with an sFlt-1-to-PlGF ratio greater than 38 (n=250) had a 2.9-fold greater likelihood of imminent delivery (ie, delivery on the day of the test) (Cox regression hazard ratio 2.9; P<.001) and shorter remaining time to delivery (median 17 [interquartile range 10-26] compared with 51 [interquartile range 30-75] days, respectively; Weibull regression factor 0.62; P<.001) than women with an sFlt-1-to-PlGF ratio of 38 or less, whether or not they developed preeclampsia. For women who did not (n=842) and did develop preeclampsia (n=199), significant correlations were seen between an sFlt-1-to-PlGF ratio greater than 38 and preterm birth (r=0.44 and r=0.46; both P<.001). Among women who did not develop preeclampsia, those who underwent iatrogenic preterm delivery had higher median sFlt-1-to-PlGF ratios at their first visit (35.3, interquartile range 6.8-104.0) than those who did not (8.4, interquartile range 3.4-30.6) or who delivered at term (4.3, interquartile range 2.4-10.9).
  
  
  
  In women undergoing evaluation for suspected preeclampsia, a serum sFlt-1-to-PlGF ratio greater than 38 is associated with a shorter remaining pregnancy duration and a higher risk of preterm delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University Vienna, Vienna, Austria; the Department of Obstetrics, Maternal-Fetal Medicine Unit, Hospital Universitari Vall d'Hebron, and the Maternal and Child Health and Development Network (SAMID) RD12/0026, Instituto de Salud Carlos III, Barcelona, Spain; the Department of Obstetrics and Gynecology, University of Liege, CHR de la Citadelle, Liege, Belgium; Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom (previously University Hospitals National Health Service Trust, Coventry, United Kingdom, during the conduct of the study); the Departments of Gynecology and Obstetrics, Oslo University Hospital and University of Oslo, Oslo, Norway; the Department of Women's and Children's Health, Karolinska University Hospital, Karolinska Institute, Stockholm, and the Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; the Pregnancy Research Centre, Department of Maternal-Fetal Medicine, Royal Women's Hospital and Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia; the Department of Obstetrics, University of Leipzig, Leipzig, Roche Diagnostics GmbH, Penzberg, and the Department of Obstetrics, Charité Universitätsmedizin, Berlin, Germany; and Roche Diagnostics International, Rotkreuz, Switzerland.
authors.forename: Harald
authors.initials: H
authors.lastname: Zeisler
authors.forename: Elisa
authors.initials: E
authors.lastname: Llurba
authors.forename: Frédéric
authors.initials: F
authors.lastname: Chantraine
authors.forename: Manu
authors.initials: M
authors.lastname: Vatish
authors.forename: Anne Cathrine
authors.initials: AC
authors.lastname: Staff
authors.forename: Maria
authors.initials: M
authors.lastname: Sennström
authors.forename: Matts
authors.initials: M
authors.lastname: Olovsson
authors.forename: Shaun P
authors.initials: SP
authors.lastname: Brennecke
authors.forename: Holger
authors.initials: H
authors.lastname: Stepan
authors.forename: Deirdre
authors.initials: D
authors.lastname: Allegranza
authors.forename: Carina
authors.initials: C
authors.lastname: Dinkel
authors.forename: Maria
authors.initials: M
authors.lastname: Schoedl
authors.forename: Peter
authors.initials: P
authors.lastname: Dilba
authors.forename: Martin
authors.initials: M
authors.lastname: Hund
authors.forename: Stefan
authors.initials: S
authors.lastname: Verlohren
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D000072483:Placenta Growth Factor / Q000097:blood*; D011225:Pre-Eclampsia / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy; D047928:Premature Birth / Q000097:blood*; D013997:Time Factors; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*
chemical_list: D015415:Biomarkers; D000072483:Placenta Growth Factor; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1