Evaluation of agreement of placental growth factor (PlGF) tests and the soluble FMS-like tyrosine kinase 1 (sFlt - 1)/PlGF ratio, comparison of predictive accuracy for preeclampsia, and relation to uterine artery Doppler and response to aspirin



Navaratnam, K, Abreu, P, Clarke, H, Jorgensen, A, Alfirevic, A ORCID: 0000-0002-2801-9817 and Alfirevic, Z ORCID: 0000-0001-9276-518X
(2017) Evaluation of agreement of placental growth factor (PlGF) tests and the soluble FMS-like tyrosine kinase 1 (sFlt - 1)/PlGF ratio, comparison of predictive accuracy for preeclampsia, and relation to uterine artery Doppler and response to aspirin. The Journal of Maternal-Fetal and Neonatal Medicine, 32 (2). 179 - 187.

[img] Text
JMFNM accepted.docx - Accepted Version

Download (88kB)

Abstract

Objectives: The objective of this study is to evaluate agreement between PlGF and sFlt-1/PlGF ratio tests and compare their predictive accuracy for pre-eclampsia in high-risk women. Also, to examine for associations of abnormal PlGF or sFlt-1/PlGF ratio with abnormal uterine artery Doppler and platelet response to aspirin. Methods: Prospective cohort study, 150 pregnant women at high risk of pre-eclampsia prescribed 75 mg aspirin daily. Uterine artery Dopplers were assessed at 20+0–23+6 weeks. At 33+0–35+6 weeks platelet function aspirin metabolites, PlGF and the sFlt-1/PlGF ratio were measured. Outcome: Measures were all pre-eclampsia and pre-eclampsia requiring delivery prior to 37 weeks. Results: Overall percent agreement was 89.3% for PlGF tests but 74.7–78% for PlGF tests and the sFlt-1/PlGF ratio. AUCs were 0.70–0.75 for prediction of any pre-eclampsia and 0.92–0.99 for preterm pre-eclampsia. We found a significant association between abnormal PlGF or sFlt-1/PlGF ratio and abnormal uterine artery Doppler (χ2 5.47, p = .019), but no association with platelet response to aspirin (χ2 0.12, p = .913). There were no associations between suboptimal aspirin adherence and either abnormal angiogenic markers or uterine artery Dopplers (χ2 0.144, 0.038, p = .704, .846, respectively). Conclusions: There was good agreement between PlGF tests and limited agreement between PlGF tests and the sFlt-1/PlGF ratio. All tests have heightened predictive accuracy for preterm pre-eclampsia. Abnormal PlGF or sFlt-1/PlGF ratio relates to abnormal uterine artery Doppler but not platelet response to aspirin.

Item Type: Article
Depositing User: Symplectic Admin
Date Deposited: 30 Apr 2018 07:18
Last Modified: 26 Nov 2020 18:10
DOI: 10.1080/14767058.2017.1373760
Related URLs:
URI: http://livrepository.liverpool.ac.uk/id/eprint/3020721