The New Possibilities in Early Diagnosis of Preeclampsia by Soluble fms-Like Tyrosine Kinase-1 and Placental Growth Factor in 16-20 Weeks Gestation.

ABSTRACT

BACKGROUND: Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) are used in diagnosing preeclampsia (PE), but their potential in early prediction in pregnant women at 16 to 20 weeks gestation (WG) has remained unexplored. METHODS: We retrospectively measured serum levels of sFlt-1 and PlGF in 120 pregnant women at 16 to 20 WG. Among these women, 16 had early-onset PE and 23 had late-onset PE. RESULTS: Compared with normal pregnancy values, in the serum of women in whom PE later developed, sFlt-1 values increased (P <.001), values of PlGF decreased (P = .001), and the sFlt-1/PlGF ratio increased (P <.001) as early as 16 to 20 WG. Receiver operating characteristic (ROC) curve analysis for the sFlt-1/PlGF ratio at 16 to 20 WG showed an area under the curve (AUC) value of 0.863 (95% confidence interval [CI], 0.788-0.918), P <.001, sensitivity of 74.4%, and specificity of 86.6% for PE in general; and AUC of 0.970 (95% CI, 0.913-0.994), P <.001, sensitivity of 100%, and specificity of 81.5% for early-onset PE only. Also, we determined the 5th and 95th percentiles for sFlt-1, PlGF, and sFlt-1/PlGF ratio values of healthy pregnant women. CONCLUSION: sFlt-1 and PlGF and, in particular, the sFlt-1/PlGF ratio can detect PE as early as 16 to 20 WG-as long as 10 to 15 weeks before PE onset.