A cross sectional study to assess the sFlt-1:PlGF ratio in pregnant women with and without preeclampsia

Abstract

Background Preeclampsia is a multisystem disorder characterized by vascular endothelial malfunction occurring after 20 weeks of gestation. Placental soluble fms-like tyrosine kinase-1 (sFlt-1) is an antiangiogenic factor and placental growth factor (PlGF) is a potent angiogenic factor. The imbalance between these factors during placenta and fetal development has been shown to play a role in endothelial damage in preeclampsia. Preeclampsia is the leading cause of maternal mortality in Nepal. This study was designed to compare the sFlt1:PLGF ratio in pregnant women with and without preeclampsia attending Tribhuvan University Teaching Hospital (TUTH). Method An observational cross-sectional study was performed in the Gynecology and Obstetrics Department of TUTH involving forty-four subjects with preeclampsia and forty-four age- and gestational-week-matched normal pregnant subjects as controls. Blood pressure, urinary protein levels, serum sFlt-1 levels, serum PlGF levels and the sFlt-1:PlGF ratio was compared in both the cases and control. The concentrations of sFlt-1 and PlGF were measured with commercially available ELISA kits. SPSS ver. 20.0 was used to analyze the data. Results There was no significant difference in age or gestational age in either study group. The ratio of the sFlt-1 and PlGF concentrations was significantly higher in women with preeclampsia (31.6 ± 9.6) than in the controls (3.2 ± 1.3). Likewise, diastolic blood pressure was significantly associated ( p -value 0.000), whereas the severity of proteinuria was not associated (p-value 0.773) with the sFlt-1:PlGF ratio in women with preeclampsia. The significantly higher ratio (35.51 ± 8.1 versus 25.4 ± 8.7) was found in women with preeclampsia who developed complications than the group of women with preeclampsia who did not develop complication. Conclusion The sFlt-1:PlGF ratio is significantly higher in Nepalese women with preeclampsia than in normal controls and this finding can be applied for further planned clinical trials.

Placenta Growth Factor and Soluble Fms-Like Tyrosine Kinase 1 in Preeclampsia and Normotensive Pregnant Nigerian Women

“…This study showed that there was a significant high sFlt-1/PIGF ratio associated with fetal adverse outcome in PE patients compared to those without any adverse outcome as found in other studies [24] [25] [26]. On the contrary there was a non-significant increase in sFlt-1/PIGF ratio in patients with adverse ma-ternal outcome amongst PE patients.…”

A Comparative Study: Gene Expression VEGF, FLT-1and KDR And level of PLGF In Preeclampsia And Normal Pregnancy.

“…(figures 5 and 6), which is consistent with a previous study (6,32,21,33),and in serum concentration VEGFR2 ( 34,35).…”

Circulating miRNAs Associated with Dysregulated Vascular and Trophoblast Function as Target-Based Diagnostic Biomarkers for Preeclampsia

“…This suggests that circulating levels of sFlt-1 and PlGF can be used as pathogenic risk factors and diagnostic and prognostic biomarkers of PE. Unfortunately, pregnant women with a high sFlt-1/PlGF ratio do not always develop hypertension and proteinuria [ 11 , 12 ]. Therefore, new accurate biomarkers directly linked to the clinical symptoms of PE are needed to improve their predictive values.…”

“…Therefore, these circulating factors have been recommended as diagnostic and prognostic biomarkers of PE. However, this antiangiogenic state does not always lead to clinical syndromes such as hypertension and proteinuria in patients with PE, although the reasons for this are still unclear [ 11 , 12 ]. Therefore, new specific biomarkers that can be directly linked to the pathogenesis of clinical features, diagnosis, and therapeutic strategies for PE still need to be discovered.…”