Angiogenesis biomarkers for the prediction of severe adverse outcomes in late-preterm preeclampsia.

OBJECTIVES: The optimal timing for delivery in non-severe late-preterm (34 + 0-36 + 6 weeks) preeclampsia (PE) is uncertain. It is attempted to reach term pregnancy safely but current clinical and analytical parameters fail to determine which cases will develop severe features that require preterm delivery. We aim to establish if angiogenic biomarkers may identify cases that would benefit from earlier delivery. STUDY DESIGN: Prospective case-control study of 96 women (n = 48 controls and n = 48 cases with PE) with maternal determinations of the sFlt-1/PlGF ratio between 34 + 0 and 36 + 6 weeks. The PE group was classified in two groups based on the need (n = 26) or not (n = 22) for preterm delivery due to criteria of severity. Diagnostic accuracy of these biomarkers for predicting preterm delivery for severe PE was evaluated. MAIN OUTCOME MEASURES: Women with PE showed higher median sFlt-1/PlGF ratio than controls (122 vs 5, p < 0.01) and lower PlGF MoM (0.7 vs 1.0, p < 0.01). However, these differences did not remain when both PE subgroups were compared. Diagnostic performance of the sFlt-1/PlGF ratio and PlGF at different cut-offs was poor for detecting PE requiring delivery before term. CONCLUSIONS: Angiogenic biomarkers are not useful to predict which late-preterm PE cases will develop severe features that require preterm delivery.