sFlt-1/PlGF ratio is associated with delivery within 7 days in women with spontaneous preterm labor

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00179906%3A_____%2F24%3A10481171" target="_blank" >RIV/00179906:_____/24:10481171 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11150/24:10481171

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=JhQwYG0n65" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=JhQwYG0n65</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.ajog.2023.11.1233" target="_blank" >10.1016/j.ajog.2023.11.1233</a>

Jazyk výsledku

angličtina

Název v původním jazyce

sFlt-1/PlGF ratio is associated with delivery within 7 days in women with spontaneous preterm labor

Popis výsledku v původním jazyce

OBJECTIVE: Spontaneous preterm labor with intact membranes (PTL) accounts for approximately one-third of all preterm deliveries, although only a minority of women with PTL deliver before 37 weeks of gestation. 1 Various clinical strategies, including several single and multiple marker models, have been suggested to precisely identify the subset of women with PTL who are at risk of imminent preterm delivery and thus require corticosteroid treatment to induce fetal lung maturity and improve neonatal outcomes. 2 Uteroplacental vasculopathy is associated with an imbalance in the maternal serum concentrations of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) in PTL. 3 Decreased PlGF and increased sFlt-1 concentrations are associated with preterm delivery in PTL and can be identi fi ed &lt; 5 weeks before spontaneous preterm delivery. 3 This study aimed to identify whether sFlt-1, PlGF concentrations, and the sFlt-1/PlGF ratio in maternal blood, measured using a clinically relevant method in a routine biochemistry laboratory, can identify subsets of women with PTL who delivered within and after 7 days of admission. STUDY DESIGN: This retrospective case control study included 172 women with singleton pregnancies complicated by PTL between the gestational ages of 22 + 0 and 34 + 6 weeks (Supplemental Table 1). Maternal blood samples were collected at the time of admission and before administration of antibiotics and corticosteroids. This retrospective study was approved by the Institutional Review Board of University Hospital Hradec (March 2023; approval number 202304 P05). Elecsys PlGF and Elecsys sFlt-1 immunoassays were used to assess PlGF and sFlt-1 concentrations and the sFlt-1/ PlGF ratio in maternal serum samples after a single freezethaw cycle. PlGF and sFlt-1 concentrations were converted into multiples of the median (MoMs) with the use of calculators available on the webpage of the Fetal Medicine Foundation (https://www.fetalmedicine.org/research/mom) and formulas published previously. 4,5 RESULTS: Correlations were found between the time interval from admission to delivery and concentrations of sFlt-1 and PlGF levels, as well as sFlt-1/PlGF ratio, in the maternal serum (sFlt-1: rho =- 0.23, P = .02; PlGF: rho = 0.42, P &lt; .0001; sFlt-1/ PlGF: rho =- 0.43, P &lt; .0001). Women who delivered within 7 days from admission had higher concentrations of sFlt-1 and sFlt-1/PlGF ratio and lower concentrations of PlGF than those who delivered after 7 days (sFlt-1: within: median 1.4 MoM vs after: 1.2 MoM; P = .005; PlGF: within: median 0.3 MoM vs after: median 0.8 MoM; P &lt; .0001; sFlt-1/PlGF: within: median 13.1 vs after: median: 4.5; P &lt; .0001; adjusted for gestational age at sampling: P &lt; .0001; Figure). The area under receiver operating characteristic curve of sFlt-1/PlGF ratio for identifying PTL with delivery within 7 days of admission was 76%. A maternal serum sFLt-1/PlGF ratio cutoff value of 14 was determined to be optimal for identifying women with PTL who delivered within 7 days of admission, with a sensitivity of 50% (46/92); speci fi city of 90% (72/80); positive predictive value of 85% (46/54); negative predictive value of 61% (72/118); odds ratio of 9.0; and positive likelihood ratio of 5.0 (Supplemental Figure, Supplemental Table 2). CONCLUSION: The sFlt-1/PlGF ratio in maternal blood, measured using a clinically relevant method in a routine biochemistry laboratory, can distinguish between the subsets of women with PTL who delivered within and those who delivered after 7 days of admission.

Název v anglickém jazyce

sFlt-1/PlGF ratio is associated with delivery within 7 days in women with spontaneous preterm labor

Popis výsledku anglicky

OBJECTIVE: Spontaneous preterm labor with intact membranes (PTL) accounts for approximately one-third of all preterm deliveries, although only a minority of women with PTL deliver before 37 weeks of gestation. 1 Various clinical strategies, including several single and multiple marker models, have been suggested to precisely identify the subset of women with PTL who are at risk of imminent preterm delivery and thus require corticosteroid treatment to induce fetal lung maturity and improve neonatal outcomes. 2 Uteroplacental vasculopathy is associated with an imbalance in the maternal serum concentrations of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) in PTL. 3 Decreased PlGF and increased sFlt-1 concentrations are associated with preterm delivery in PTL and can be identi fi ed &lt; 5 weeks before spontaneous preterm delivery. 3 This study aimed to identify whether sFlt-1, PlGF concentrations, and the sFlt-1/PlGF ratio in maternal blood, measured using a clinically relevant method in a routine biochemistry laboratory, can identify subsets of women with PTL who delivered within and after 7 days of admission. STUDY DESIGN: This retrospective case control study included 172 women with singleton pregnancies complicated by PTL between the gestational ages of 22 + 0 and 34 + 6 weeks (Supplemental Table 1). Maternal blood samples were collected at the time of admission and before administration of antibiotics and corticosteroids. This retrospective study was approved by the Institutional Review Board of University Hospital Hradec (March 2023; approval number 202304 P05). Elecsys PlGF and Elecsys sFlt-1 immunoassays were used to assess PlGF and sFlt-1 concentrations and the sFlt-1/ PlGF ratio in maternal serum samples after a single freezethaw cycle. PlGF and sFlt-1 concentrations were converted into multiples of the median (MoMs) with the use of calculators available on the webpage of the Fetal Medicine Foundation (https://www.fetalmedicine.org/research/mom) and formulas published previously. 4,5 RESULTS: Correlations were found between the time interval from admission to delivery and concentrations of sFlt-1 and PlGF levels, as well as sFlt-1/PlGF ratio, in the maternal serum (sFlt-1: rho =- 0.23, P = .02; PlGF: rho = 0.42, P &lt; .0001; sFlt-1/ PlGF: rho =- 0.43, P &lt; .0001). Women who delivered within 7 days from admission had higher concentrations of sFlt-1 and sFlt-1/PlGF ratio and lower concentrations of PlGF than those who delivered after 7 days (sFlt-1: within: median 1.4 MoM vs after: 1.2 MoM; P = .005; PlGF: within: median 0.3 MoM vs after: median 0.8 MoM; P &lt; .0001; sFlt-1/PlGF: within: median 13.1 vs after: median: 4.5; P &lt; .0001; adjusted for gestational age at sampling: P &lt; .0001; Figure). The area under receiver operating characteristic curve of sFlt-1/PlGF ratio for identifying PTL with delivery within 7 days of admission was 76%. A maternal serum sFLt-1/PlGF ratio cutoff value of 14 was determined to be optimal for identifying women with PTL who delivered within 7 days of admission, with a sensitivity of 50% (46/92); speci fi city of 90% (72/80); positive predictive value of 85% (46/54); negative predictive value of 61% (72/118); odds ratio of 9.0; and positive likelihood ratio of 5.0 (Supplemental Figure, Supplemental Table 2). CONCLUSION: The sFlt-1/PlGF ratio in maternal blood, measured using a clinically relevant method in a routine biochemistry laboratory, can distinguish between the subsets of women with PTL who delivered within and those who delivered after 7 days of admission.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30214 - Obstetrics and gynaecology

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2024

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

American Journal of Obstetrics &amp; Gynecology

ISSN

0002-9378

e-ISSN

1097-6868

Svazek periodika

230

Číslo periodika v rámci svazku

4

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

5

Strana od-do

"e38"-"e42"

Kód UT WoS článku

001226118400001

EID výsledku v databázi Scopus

2-s2.0-85189565993