Midpregnancy prediction of pre-eclampsia using serum biomarkers sFlt-1 and PlGF
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Al-Amin, Ahmed
Stolarek, Caroline
Kane, Stefan C
Rolnik, Daniel Lorber
White, Adrienne
Costa, Fabricio da Silva
Brennecke, Shaun
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Abstract
Objectives: Pre-eclampsia remains a significant cause of morbidity and mortality. Placental biomarkers soluble Fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) have been investigated previously for their ability to predict pre-eclampsia. We compared the performance of these biomarkers for midpregnancy pre-eclampsia prediction using three different immunoassay platforms. Study design: Prospective study including singleton pregnancies 19–22 weeks’ gestation. Maternal bloods were collected at recruitment. Screening performances using receiver operating characteristic (ROC) curves for PlGF and sFlt-1/PlGF ratio raw data and MoM values in isolation were evaluated for three immunoassay platforms using selected cut-off values. Main outcome measures: Pre-eclampsia was defined as early-onset (<34 weeks’ at delivery) and preterm (<37 weeks’ at delivery). Results: For prediction of preterm pre-eclampsia, PlGF MoM and sFlt-1/PlGF ratio MoM performed similarly, with areas under the curve (AUC), detection rates (DR) and false positive rates (FPR) for PlGF MoM and sFlt-1/PlGF ratio MoM being 0.77–0.79 and 0.71–0.74, 62.5% for both and 9.7–14.9 and 10.7–17.7, respectively. For the prediction of early-onset pre-eclampsia, sFlt-1/PlGF ratio raw data and MoM values performed similarly, with AUC, DR and FPR being 0.92–0.97 and 0.93–0.96, 100% for both, and 4.13–16.9 and 9.4–12.2, respectively. Conclusions: For midpregnancy prediction of preterm pre-eclampsia, PlGF MoM for all three platforms and sFlt-1/PlGF ratio MoM for the two platforms that tested sFlt-1 performed similarly. For midpregnancy prediction of early-onset pre-eclampsia at midpregnancy, sFlt-1/PlGF ratio raw data and MoM values using the early-onset cut-off for the two platforms that tested sFlt-1 gave similar performance from a clinical perspective.
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Pregnancy Hypertension
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16
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Paediatrics
Reproductive medicine
Science & Technology
Life Sciences & Biomedicine
Obstetrics & Gynecology
Peripheral Vascular Disease
Cardiovascular System & Cardiology
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Black, C; Al-Amin, A; Stolarek, C; Kane, SC; Rolnik, DL; White, A; Costa, FDS; Brennecke, S, Midpregnancy prediction of pre-eclampsia using serum biomarkers sFlt-1 and PlGF, Pregnancy Hypertension, 2019, 16, pp. 112-119