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<p>We aimed to investigate the effects of serum sFlt-1/PlGF ratio levels in women with suspected or confirmed early-onset preeclampsia and super-imposed preeclampsia (PE/SPE) on composite and individual adverse maternal and fetal outcomes, stratified by gestational age at blood sampling (&lt;34, 34–36, and ≥37 weeks). We also evaluated whether serum sFlt-1/PlGF ratio levels influenced the time interval from blood sampling to delivery. This prospective cohort study assessed serum levels of sFlt-1, PlGF, and the sFlt-1/PlGF ratio in women with suspected or confirmed PE/SPE admitted to a tertiary maternal-fetal-neonatal center between 2012 and 2023. Finally, 241 women were analyzed. An elevated sFlt-1/PlGF ratio at &lt;34 weeks of gestation, but not at 34–36 or ≥37 weeks, was significantly associated with composite adverse maternal and fetal outcomes in women with suspected or confirmed PE/SPE. An sFlt-1/PlGF ratio of 400 was identified as the optimal cut-off level for predicting composite adverse maternal and fetal outcomes at &lt;34 weeks. Among women with suspected or confirmed early-onset PE/SPE, HELLP syndrome alone was significantly associated with an sFlt-1/PlGF ratio ≥400. Additionally, the sFlt-1/PlGF ratio was significantly higher in women with HELLP syndrome, abnormal umbilical artery Doppler findings, or non-reassuring fetal status (NRFS) requiring immediate delivery, compared with those without these conditions. Furthermore, the interval from blood sampling to delivery significantly shortened with increasing sFlt-1/PlGF ratio. In conclusion, elevated sFlt-1/PlGF ratios were significantly associated with HELLP syndrome, abnormal umbilical artery Doppler findings, and NRFS requiring immediate delivery in women with suspected or confirmed early-onset PE/SPE.</p><p></p>

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Elevated sFlt-1/PlGF ratio in women with suspected or confirmed early-onset preeclampsia and super-imposed preeclampsia complicated by HELLP syndrome as well as abnormal umbilical artery Doppler findings and non-reassuring fetal status requiring immediate delivery: a prospective cohort study

  • 期刊论文

  • 发表日期：

    2025年10月20日

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  • Akihide Ohkuchi,
  • Hirotada Suzuki,
  • Chikako Hirashima,
  • Kayo Takahashi,
  • Manabu Ogoyama,
  • Kenji Horie,
  • Rie Usui,
  • Hironori Takahashi,
  • Hiroyuki Fujiwara,
  • Tatsuo Yamamoto

摘要

We aimed to investigate the effects of serum sFlt-1/PlGF ratio levels in women with suspected or confirmed early-onset preeclampsia and super-imposed preeclampsia (PE/SPE) on composite and individual adverse maternal and fetal outcomes, stratified by gestational age at blood sampling (<34, 34–36, and ≥37 weeks). We also evaluated whether serum sFlt-1/PlGF ratio levels influenced the time interval from blood sampling to delivery. This prospective cohort study assessed serum levels of sFlt-1, PlGF, and the sFlt-1/PlGF ratio in women with suspected or confirmed PE/SPE admitted to a tertiary maternal-fetal-neonatal center between 2012 and 2023. Finally, 241 women were analyzed. An elevated sFlt-1/PlGF ratio at <34 weeks of gestation, but not at 34–36 or ≥37 weeks, was significantly associated with composite adverse maternal and fetal outcomes in women with suspected or confirmed PE/SPE. An sFlt-1/PlGF ratio of 400 was identified as the optimal cut-off level for predicting composite adverse maternal and fetal outcomes at <34 weeks. Among women with suspected or confirmed early-onset PE/SPE, HELLP syndrome alone was significantly associated with an sFlt-1/PlGF ratio ≥400. Additionally, the sFlt-1/PlGF ratio was significantly higher in women with HELLP syndrome, abnormal umbilical artery Doppler findings, or non-reassuring fetal status (NRFS) requiring immediate delivery, compared with those without these conditions. Furthermore, the interval from blood sampling to delivery significantly shortened with increasing sFlt-1/PlGF ratio. In conclusion, elevated sFlt-1/PlGF ratios were significantly associated with HELLP syndrome, abnormal umbilical artery Doppler findings, and NRFS requiring immediate delivery in women with suspected or confirmed early-onset PE/SPE.