JOURNAL ARTICLE

Vasoactive agents for the prediction of early- and late-onset preeclampsia in a high-risk cohort

Pia M Villa, Esa Hämäläinen, Annukka Mäki, Katri Räikkönen, Anu-Katriina Pesonen, Pekka Taipale, Eero Kajantie, Hannele Laivuori
BMC Pregnancy and Childbirth 2013 May 12, 13: 110
23663420

BACKGROUND: To evaluate the soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and sFlt-1/PlGF ratio for the prediction of early- and late-onset preeclampsia in a high-risk cohort.

METHODS: We studied serial serum samples collected prospectively at 12+0-14+0, 18+0-20+0, and 26+0-28+0 weeks+days of gestation in 6 women who developed early-onset preeclampsia (before 34 weeks of gestation) and in 21 women who developed late-onset preeclampsia (after 34 weeks of gestation) with automated ElecSys 2010 immunoanalyzer (Roche Diagnostics, Germany). Twenty-six high-risk women and 53 women without risk factors with normal pregnancies served as controls.

RESULTS: Serum PlGF concentrations were lower at 18+0 to 20+0, and 26+0 to 28+0 weeks of gestation in women who developed early-onset preeclampsia compared to women who developed late-onset preeclampsia and to controls (p<0.05 for all comparisons). At 18+0 to 20+0 weeks of gestation area under the receiver-operating characteristic curve (AUC) for serum PlGF was 99.8% (p=0.0007, 95% CI 99.0-100.0). At 26+0 to 28+0 weeks of gestation serum sFlt-1/PlGF ratio explicitly detects those women who developed early-onset preeclampsia (AUC 100.0%, p=0.0007, 95% CI 100-100). Amongst women with late-onset preeclampsia, those who developed severe form of the disease (N=8) had significantly higher serum sFlt-1 concentrations at all three timepoints (p=0.004, p=0.006, and p=0.003, respectively) compared to women with non-severe form (N=13).

CONCLUSIONS: Low serum PlGF concentration predicts early-onset preeclampsia from the second trimester and elevated serum sFlt-1/PlGF ratio from 26 to 28 weeks of gestation. Elevated serum sFlt-1 concentration in the first trimester in women who later develop late-onset, severe preeclampsia may suggest different etiology compared to the late-onset non-severe form of the disease.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
23663420
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"