Competing risks model in screening for preeclampsia by serum placental growth factor and soluble fms-like tyrosine kinase-1 at 30-33 weeks’ gestation
Abstract
OBJECTIVE: To assess the risk for preeclampsia (PE) by maternal characteristics, serum placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) at 30-33 weeks' gestation. METHODS: This was a screening study in singleton pregnancies including 2,140 that subsequently developed PE and 83,615 that were unaffected by PE, gestational hypertension or delivery of small-for-gestational-age neonates (normal group). We developed a survival time model for the time of delivery for PE by combination of maternal characteristics and history with PlGF and sFlt-1 multiple of the median (MoM) values (biochemical test). Data on third-trimester PlGF and sFlt-1 were available in 118 cases of PE and 3,734 of normal group. The detection rate (DR) of PE requiring delivery within 4, 6 and 8 weeks of the visit was estimated. RESULTS: In pregnancies with PE, the log10 MoM values of PlGF and sFlt-1 were linearly related to gestational age at delivery. Screening by the biochemical test detected 100, 76, and 62% of PE with delivery within 4, 6 and 8 weeks of the visit, at a fixed false-positive rate of 5%. INTERPRETATION: Testing by PlGF and sFlt-1 at 30-33 weeks could identify all pregnancies developing PE and requiring delivery within the subsequent 4 weeks.
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There is excessive production of sVEGFR-1 and soluble endoglin in the uterus of preeclamptic patients proportional to the severity of the disease.
“There is excessive production of sVEGFR-1 and soluble endoglin in the uterus of preeclamptic patients(121) proportional to the severity of the disease (151–153)”
From Metformin, the Aspirin of the 21st Century: Its Role in Gestational Diabetes Mellitus, Prevention of Preeclampsia and Cancer, and the Promotion of Longevity (2017) · cites this paper as [152]
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- Authors
- Lai, J., Garcia-Tizon Larroca, S., Peeva, G., Poon, L. C., Wright, D., & Nicolaides, K. H.
- Affiliations
- Harris Birthright Research Centre for Fetal Medicine (GB)
- University of Exeter (GB)
- Venue
- Fetal Diagnosis and Therapy
- Publisher
- S. Karger AG
- Published
- 2014
- Volume
- 35
- Issue
- 4
- Pages
- 240-248
- ISSN
- 1015-3837 (ISSN-L)
- 1421-9964
- OpenAlex
- W1972743675
- Cited by
- 63
- References
- 36
- Citations by year
- 2026: 3 · 2025: 1 · 2023: 4 · 2022: 3 · 2021: 3 · 2020: 4 · 2019: 12 · 2018: 4 · 2017: 3 · 2016: 11 · 2015: 10 · 2014: 5
- FWCI
- 10.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Fetal Diagnosis and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (ACF-2013-21-016)
- Fetal Medicine Foundation
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- preeclampsia, preeclampsia screening, placental growth factor, soluble fms-like tyrosine kinase-1, sFlt-1/PlGF ratio, third trimester, gestational age at delivery, detection rate, false positive rate, singleton pregnancy, gestational hypertension
- MeSH terms
- Placenta Growth Factor, Adult, Female, Gestational Age, Humans, Pre-Eclampsia, Pregnancy, Pregnancy Outcome, Pregnancy Proteins, Pregnancy Trimester, Third, Regression Analysis, Biomarkers, Risk Assessment, Vascular Endothelial Growth Factor Receptor-1
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