The sFlt-1/PlGF ratio as predictor of Maternal adverse outcome in patients with suspected or placental insufficiency

Background sFlt-1/PlGF ratio has been proposed to herald adverse Pregnancy outcome (APO). Several authors have proposed the use of a continuous scale but most use specific cut-offs to evaluate the risk of APO, but the proposed range varies widely. The aim, is to evaluate if the Maternal adverse outcome (AO) prediction occurs in a stepwise manner, and if this was the case, which would be the point yielding the highest accuracy. Methods This is an observational retrospective cohort study. Singleton pregnancies, between 20 to 40 weeks were selected according the levels of sFlt-1/PlGF; three groups (n = 60 each): High ≥ 655, Intermediate ≥ 85 to < 655 and Low < 85. From hospital records we retrieve data, and outcome, also we quantitate the PE risk. We compared the groups, to determine the clinical utility of the sFlt1/PlGF ratio in prediction of Maternal AO, we used ROC analysis, and to develop a predictive model of Maternal AO a binary multivariate logistic regression was used. Results At entry a different degree of severity is observed for groups: High > Intermediate > Low, for: Systolic Blood pressure, Mean Blood pressure, Angiogenic markers, AST, ALT. Also a positive correlation was found between the sFlt-1/PlGF and the afore mentioned variables. We observed a potency order for the Maternal AO, from more to less manifestations High > Intermediate > Low (p < 0,001). sFlt1/PlGF ratio has the highest AUC for predicting Maternal AO than any other single parameter.