Background
Methods
Selection and inclusion criteria of patients
Sample collection and immunoassays
Statistical analysis
Results
Patients’ characteristics
Characteristic | All patients (n = 50) | PE (n = 12) | IUGR (n = 6)#
| GH (n = 16) | Others (n = 16) | P-value |
---|---|---|---|---|---|---|
Age, y
| ||||||
Mean ± SD | 29.7 ± 4.9 | 29.8 ± 3.9 | 33.3 ± 4.8 | 28.3 ± 3.6 | 29.6 ± 6.3 | 0.206* |
Minimum - maximum | 19 - 40 | 24 - 38 | 28 - 40 | 22 - 34 | 19 - 39 | |
Gravidity
| 0.613** | |||||
Median | 1 | 1 | 2 | 1 | 2 | |
Minimum - maximum | 1 - 9 | 1 - 9 | 1 - 8 | 1 - 5 | 1 - 5 | |
Parity
| 0.612** | |||||
Median | 0 | 0 | 0 | 0 | 0 | |
Minimum - maximum | 0 - 5 | 0 - 4 | 0 - 5 | 0 - 2 | 0 - 1 | |
Body mass index (pregravid), kg/m
2
| 0.132* | |||||
Mean ± SD | 27.1 ± 8.2 | 30.6 ± 8.0 | 21.7 ± 3.2 | 28.1 ± 9.1 | 25.6 ± 6.3 | |
Minimum - maximum | 14.5 - 47.0 | 19.8 - 45.0 | 18.7 - 27.3 | 14.5 - 45.7 | 18.8 - 47.0 | |
Chronic hypertension, n (%)
| 8 (16.0%) | 4 (33.3%) | 0 (0.0%) | 4 (25.0%) | 0 (0.0%) | 0.049*** |
Thrombophilia, n (%)
| 5 (10.0%) | 0 (0.0%) | 0 (0.0%) | 3 (18.8%) | 2 (12.5%) | 0.755*** |
Nicotine abuse, n (%)
| 14 (28.0%) | 5 (41.7%) | 1 (16.7%) | 6 (37.5%) | 2 (12.5%) | 0.238*** |
Highest systolic blood pressure, mmHg
| < 0.001* | |||||
Mean ± SD | 143.2 ± 23.1 | 165.8 ± 21.2 | 128.7 ± 5.4 | 149.4 ± 20.0 | 124.7 ± 9.9 | |
Minimum - maximum | 110 - 200 | 140 - 200 | 120 - 135 | 130 - 200 | 110 - 140 | |
Highest diastolic blood pressure, mmHg
| < 0.001* | |||||
Mean ± SD | 90.4 ± 17.6 | 110.5 ± 13.4 | 79.7 ± 6.2 | 91.8 ± 15.9 | 77.3 ± 7.1 | |
Minimum - maximum | 60 - 130 | 90 - 130 | 70 - 86 | 60 - 124 | 60 - 90 | |
Proteinuria, mg/d
| ||||||
Mean ± SD | 1180 ± 2524 | 2613 ± 3394 | n.a. | 157 ± 196 | n.a. | |
Minimum - maximum | 0 - 9986 | 109 - 9986 | n.a. | 0 - 283 | n.a. | |
Placenta weight, g
| 0.129* | |||||
Mean ± SD | 324 ± 98 | 300 ± 86 | 322 ± 29 | 286 ± 145 | 443 ± 71 | |
Minimum - maximum | 124 - 510 | 182 - 461 | 283 - 364 | 124 - 476 | 369 - 510 | |
Amnion fluid index (AFI), n (%)
| 0.839*** | |||||
Oligohydramnion (AFI ≤ 8) | 13 (26.0%) | 3 (25.0%) | 2 (33.3%) | 4 (25.0%) | 4 (25.0%) | |
Polyhydramnion (AFI > 18) | 7 (14.0%) | 3 (25.0%) | 1 (16.7%) | 1 (6.3%) | 2 (12.5%) | |
Birth weight, g
| < 0.001* | |||||
Mean ± SD | 2588 ± 809 | 1859 ± 658 | 2270 ± 303 | 2588 ± 750 | 3175 ± 626 | |
Minimum - maximum | 620 - 3940 | 890 - 2980 | 1750 - 2620 | 620 - 3610 | 1860 - 3940 | |
Percentile of birth weight, n (%)
| ||||||
SGA (<10th centile) | 16 (32.0%) | 5 (41.7%) | 6 (100.0%) | 6 (37.5%) | 0 (0.0%) | |
LGA (>90th centile) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | |
5´-APGAR-Score
| 0.398** | |||||
Median | 10 | 9 | 10 | 10 | 10 | |
Minimum - maximum | 8 - 10 | 8 - 10 | 9 - 10 | 8 - 10 | 9 - 10 | |
Induction of lung maturation, n (%)
| 13 (26.0%) | 4 (33.3%) | 6 (100.0%) | 2 (12.5%) | 1 (6.3%) | 0.019*** |
Newborns < 34 + 0 weeks, n (%)
| 7 (14.0%) | 5 (41.7%) | 0 (0.0%) | 2 (12.5%) | 0 (0.0%) | 0.008*** |
Gestational age at delivery, weeks + days
| 0.009** | |||||
Mean (w + d) ± SD (d) | 37 + 2 ± 24 | 34 + 4 ± 26 | 37 + 5 ± 5 | 37 + 4 ± 25 | 38 + 6 ± 17 | |
Minimum - maximum | 26 + 4 - 42 + 0 | 27 + 4 - 40 + 3 | 36 + 5 - 39 + 0 | 26 + 2 – 41 + 0 | 34 + 1 - 42 + 0 |
Prediction of PE by UtADV, PlGF, sFLT-1, and the sFLT-1/PlGF ratio
PE (n = 12) | No PE (n = 38) | P-valuea
| Others (n = 16) (Uncomplicated) | GH (n = 16) | P-valueb
| Normotensive IUGR (n = 6) | P-valuec
| Delivery < 34 weeks (n = 7) | Delivery ≥ 34 weeks (n = 44) | P-valued
| |
---|---|---|---|---|---|---|---|---|---|---|---|
PlGF (pg/mL) | 105.6 (70.7-248.7) | 218.5 (131.2-322.5) | 0.041 | 274.6 (157.9-413.6) | 198.7 (91.5-305.3) | 0.142 | 165.9 (72.1-220.7) | 0.033 | 75.1 (64.6-131.7) | 221.7 (117.4-336.4) | 0.003 |
sFLT-1 (pg/mL) | 1879.0 (1379.5-2168.3) | 1144.0 (842.2-1882.8) | 0.046 | 1458.0 (1018.8-1896.3) | 1032.6 (826.8-1649.8) | 0.258 | 1324.4 (673.1-2012.0) | 0.768 | 2158.0 (1858.0-3463.0) | 1298.0 (846.1-1876.0) | 0.008 |
sFLT-1/PlGF ratio | 18.8 (4.8-29.1) | 6.2 (3.4-8.8) | 0.022 | 5.9 (2.9-8.6) | 5.9 (3.6-9.1) | 0.366 | 8.6 (4.0-19.6) | 0.161 | 29.4 (14.1-53.9) | 6.0 (3.4-9.0) | 0.001 |
Chi-Square P-value | Sensitivity | Specificity | PPV | NPV | LR + (95% CI) | LR- (95% CI) | OR (95% CI) | ||
---|---|---|---|---|---|---|---|---|---|
PE (n = 12)
| PlGF | 0.027 | 58.3% | 78.9% | 46.7% | 85.7% | 2.77 (1.27-6.04) | 0.53 (0.27-1.05) | 5.25 (1.31-21.03) |
sFLT-1 | 0.240 | 16.7% | 94.7% | 50.0% | 78.3% | 3.17 (0.50-20.13) | 0.88 (0.68-1.15) | 3.60 (0.45-28.86) | |
sFLT-1/PlGF ratio | <0.001 | 66.7% | 89.5% | 66.7% | 89.5% | 6.33 (2.31-17.38) | 0.37 (0.17-0.84) | 17.0 (3.50-83.02) | |
Gestational hypertension (n = 16)
| PlGF | 0.514 | 37.5% | 73.5% | 40.0% | 71.4% | 1.42 (0.61-3.30) | 0.85 (0.55-1.31) | 1.67 (0.47-5.92) |
sFLT-1 | 1.000 | 6.3% | 91.2% | 25.0% | 67.4% | 0.71 (0.08-6.29) | 1.03 (0.87-1.21) | 0.69 (0.067-7.19) | |
sFLT-1/PlGF ratio | 0.292 | 12.5% | 70.6% | 16.7% | 63.2% | 0.43 (0.11-1.72) | 1.24 (0.93-1.65) | 0.34 (0.07-1.79) | |
IUGR (n = 6)
| PlGF | 0.654 | 16.7% | 68.2% | 6.7% | 85.7% | 0.52 (0.08-3.30) | 1.22 (0.81-1.84) | 0.43 (0.05-4.02) |
sFLT-1 | 1.000 | 0.0% | 90.9% | 0.0% | 87.0% | 0.00 | 1.10 (1.00-1.21) | 0.00 | |
sFLT-1/PlGF ratio | 1.000 | 16.7% | 75.0% | 8.3% | 86.8% | 0.67 (0.10-4.29) | 1.11 (0.75-1.65) | 0.60 (0.06-5.71) | |
Induced delivery < 34 weeks (n = 7)
| PlGF | 0.176 | 57.1% | 74.4% | 26.7% | 91.4% | 2.23 (0.98-5.07) | 0.58 (0.34-1.38) | 3.88 (0.75-20.12) |
sFLT-1 | 0.089 | 28.6% | 95.4% | 50.3% | 89.1% | 6.14 (1.03-36.79) | 0.75 (0.47-1.20) | 8.20 (0.94-71.73) | |
sFLT-1/PlGF ratio | <0.001 | 85.7% | 86.1% | 50.1% | 97.4% | 6.14 (2.76-13.69) | 0.17 (0.03-1.02) | 37.00 (3.76-363.91) | |
Early-onset PE (n = 9)
| PlGF | 0.220 | 50.0% | 73.8% | 26.7% | 88.6% | 1.91 (0.81-4.51) | 0.68 (0.33-1.39) | 2.82 (0.60-13.24) |
sFLT-1 | 0.115 | 25.0% | 95.2% | 50.0% | 87.0% | 5.25 (0.86-32.02) | 0.79 (0.53-1.18) | 6.67 (0.79-56.64) | |
sFLT-1/PlGF ratio | 0.001 | 75.0% | 85.7% | 50.0% | 94.7% | 5.25 (2.26-12.18) | 0.29 (0.09-0.98) | 18.00 (2.92-110.96) | |
Late-onset PE (n = 3)
| PlGF | 0.075 | 75.0% | 73.9% | 20.0% | 97.1% | 2.88 (1.36-6.06) | 0.34 (0.06-1.86) | 8.50 (0.81-89.75) |
sFLT-1 | 1.000 | 0.0% | 91.3% | 0.0% | 91.3% | 0.00 | 1.10 (1.00-1.20) | 0.00 | |
sFLT-1/PlGF ratio | 0.240 | 50.0% | 78.3% | 16.7% | 94.7% | 2.30 (0.75-7.07) | 0.64 (0.24-1.72) | 3.60 (0.46-28.86) |
AUC | Cut-off | Sensitivity | Specificity | PPV | NPV | ||
---|---|---|---|---|---|---|---|
PE (n = 12) | PlGF | 0.697 | 133.8 | 75.0% | 76.3% | 50.0% | 90.6% |
sFLT-1 | 0.693 | 1171.5 | 91.7% | 52.6% | 37.9% | 95.3% | |
sFLT-1/PlGF ratio | 0.721 | 13.0 | 66.7% | 86.8% | 61.5% | 89.2% | |
EO PE (n = 9) | sFLT-1/PlGF ratio | 0.735 | 13.0 | 75.0% | 83.3% | 51.4% | 93.4% |
Gestational hypertension (n = 16) | PlGF | 0.494 | 117.6 | 37.5% | 70.6% | 37.5% | 70.6% |
sFLT-1 | 0.364 | 590.5 | 100.0% | 11.8% | 34.8% | 100.0% | |
sFLT-1/PlGF ratio | 0.456 | 2.3 | 100.0% | 8.8% | 34.0% | 100.0% | |
IUGR (n = 6) | PlGF | 0.640 | 262.3 | 100.0% | 38.6% | 18.2% | 100.0% |
sFLT-1 | 0.439 | 1751.0 | 50.0% | 63.6% | 15.8% | 90.3% | |
sFLT-1/PlGF ratio | 0.564 | 8.0 | 66.7% | 56.8% | 17.4% | 92.6% | |
Induced delivery < 34 weeks (n = 7) | PlGF | 0.834 | 133.8 | 85.7% | 72.1% | 33.3% | 96.9% |
sFLT-1 | 0.807 | 1850.5 | 85.7% | 74.4% | 35.3% | 97.0% | |
sFLT-1/PlGF ratio | 0.877 | 13.0 | 85.7% | 83.7% | 46.1% | 97.3% |