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sFlt-1/PlGF for prediction of early-onset pre-eclampsia: STEPS (Study of Early Pre-eclampsia in Spain)

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Delgado, JL
  • De la Calle, M
  • Garcia-Hernandez, JA
  • Escudero, AI
  • Campillos, JM
  • Sarabia, MD
  • Laiz, B
  • Duque, M
  • Calmarza, P
  • Hund, M
  • Alvarez, FV
  • STEPS investigators

Grupos

Abstract

Objective A high ratio of soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) has been linked to pre-eclampsia (PE). We evaluated the sFlt-1/PlGF ratio as a predictive marker for early-onset PE in women at risk of PE. Methods This prospective, Spanish, multicenter study included pregnant women with a risk factor for PE, including intrauterine growth restriction, PE, eclampsia or hemolysis, elevated liver enzymes and low platelet count syndrome in previous pregnancy, pregestational diabetes or abnormal uterine artery Doppler. The primary objective was to show that the sFlt-1/PlGF ratio at 20, 24 and 28 weeks' gestation was predictive of early-onset PE (<34+0 weeks). Serum sFlt-1 and PlGF were measured at 20, 24 and 28 weeks. Multivariate logistic regression was used to develop a predictive model. Results A total of 819 women were enrolled, of which 729 were suitable for analysis. Of these, 78 (10.7%) women developed PE (24 early onset and 54 late onset). Median sFlt-1/PlGF ratio at 20, 24 and 28 weeks was 6.3 (interquartile range (IQR), 4.1-9.3), 4.0 (IQR, 2.6-6.3) and 3.3 (IQR, 2.0-5.9), respectively, for women who did not develop PE (controls); 14.5 (IQR, 5.5-43.7), 18.4 (IQR, 8.2-57.9) and 51.9 (IQR, 11.5-145.6) for women with early-onset PE; and 6.7 (IQR, 4.6-9.9), 4.7 (IQR, 2.8-7.2) and 6.0 (IQR, 3.8-10.5) for women with late-onset PE. Compared with early-onset PE, the sFlt-1/PlGF ratio was significantly lower in controls (P<0.001 at each timepoint) and in women with chronic hypertension (P<0.001 at each timepoint), gestational hypertension (P<0.001 at each timepoint) and late-onset PE (P<0.001 at each timepoint). A prediction model for early-onset PE was developed, which included the sFlt-1/PlGF ratio plusmean arterial pressure, being parous and previous PE, with areas under the receiver-operating characteristics curves of 0.86 (95% CI, 0.77-0.95), 0.91 (95% CI, 0.85-0.97) and 0.93 (95% CI, 0.86-0.99) at 20, 24 and 28weeks, respectively, and was superior to models using the sFlt-1/PlGF ratio alone or uterine artery mean pulsatility index. Conclusions The sFlt-1/PlGF ratio can improve prediction of early-onset PE for women at risk of this condition. Copyright (C) 2016 ISUOG. Published by John Wiley & Sons Ltd.

Datos de la publicación

ISSN/ISSNe:
0960-7692, 1469-0705

ULTRASOUND IN OBSTETRICS & GYNECOLOGY  WILEY-BLACKWELL

Tipo:
Article
Páginas:
373-382
Factor de Impacto:
2,647 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 48

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Keywords

  • biomarker; early-onset prediction; hypertension; PlGF; pre-eclampsia; sFlt-1; sFlt-1/PlGF ratio

Campos de estudio

Proyectos asociados

APLICACION DE TECNICAS LAPLACIANAS PARA LA MONITORIZACION DE LA ACTIVIDAD ELECTRICA DEL MUSCULO LISO HUMANO:ENFASIS EN ELECTROHISTEROGRAMA (LAMOHIS)

Investigador Principal: ALFREDO JOSÉ PERALES MARÍN

LAMOHIS PLAN NACIONAL I+D+I 2008-2011 . 2010

COMPREHENSIVE, INTEGRATIVE AND GENOMIC APPROACH TO THE UNDERSTANDING AND TREATMENT OF CANCER AND LEUKEMIA.

Investigador Principal: MIGUEL ÁNGEL SANZ ALONSO

PIE13/00046 . INSTITUTO DE SALUD CARLOS III; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2014

CON-CIENCIA-YV: PILDORAS DE SALUD

FCT-13-7457_FECYT_2013 . MINISTERIO DE ECONOMIA Y COMPETITIVIDAD; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2013

PAPEL DEL FACTOR DE CRECIMIENTO PLACENTARIO EN EL MANEJO DE LA PREECLAMPSIA NO SEVERA: ESTUDIO ALEATORIZADO

Investigador Principal: ALFREDO JOSÉ PERALES MARÍN

PI15/01935 . INSTITUTO DE SALUD CARLOS III . 2016

ESTUDIO PROSPECTIVO, DE SEGUIMIENTO, DE NIÑOS DE 23 A 25 MESES, NACIDOS DE MADRES QUE RECIBIERON CAPROATO DE HIDROXIPROGESTERONA INYECTABLE, 250 MG/ML O VEHICULO, PARA LA PREVENCION DEL PARTO PREMATURO.

Investigador Principal: ALFREDO JOSÉ PERALES MARÍN

17P-FU-004 . 2012

ENSAYO ABIERTO, PROSPECTIVO, NO ALEATORIZADO, MULTICÉNTRICO PARA EVALUAR EL EFECTO DE PIEL BLANQUEADA EN LOS RESULTADOS DE CALIDAD DE VIDA RELACIONADA CON LA SALUD A LAS 16 Y 52 SEMANAS EN PACIENTES CON PSORIASIS EN PLACAS DE MODERADA A GRAVE TRATADOS CON 300 MG SECUKINUMAB S.C. CON O SIN EXPOSICIÓN PREVIA A TERAPIA SISTÉMICA.

Investigador Principal: RAFAEL BOTELLA ESTRADA

CAIN457A3401 . 2016

DETERMINACION DE LA TIROSIN-KINASA 1 SOLUBLE FMS-LIKE (SFLT-1) Y DEL FACTOR DE CRECIMIENTO PLACENTARIO (PIGF) COMO POSIBLES MARCADORES PARA EL DIAGNOSTICO PRECOZ Y PRONOSTICO DE LA PREECLAMPSIA.

Investigador Principal: ALFREDO JOSÉ PERALES MARÍN

SFLT-1/PIGF . 2010

EFICACIA DE RAPAMICINA EN PREVENCION SECUNDARIA DE TUMORES CUTANEOS EN TRASPLANTADOS RENALES. ESTUDO ABIERTO, ALEATORIZADO COMPARANDO RAPIMICINA CON INHIBIDORES DE CALCINEURINA.

Investigador Principal: JAIME SANCHEZ PLUMED

TUMORAPA-1 . 2007

LATENT. ESTIMACIÓN DE LA PREVALENCIA DE TUBERCULOSIS LATENTE EN PACIENTES CON PSORIASIS EN PLACAS MODERADA A GRAVE.

Investigador Principal: CONRAD PUJOL MARCO

PFI-ETA-2010-04

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