Can maternal serum soluble fms‐like tyrosine kinase‐1 to placental growth factor levels at term anticipate adverse pregnancy outcomes?
Sarah A. Corker, Thomas J. Cade, Shaun P. BrenneckeAbstract
Aim
To evaluate if maternal serum soluble fms‐like tyrosine kinase‐1(sFlt‐1) to placental growth factor (PlGF) ratio levels at term can anticipate the following adverse pregnancy outcomes: small for gestational age neonates; operative delivery for suspected fetal welfare compromise; and neonatal compromise.
Methods
A retrospective analysis of a single hospital database containing antenatal soluble fms‐like tyrosine kinase‐1 to placental growth factor (sFlt‐1/PlGF) ratio results together with associated demographic, clinical and investigative information. Subjects with antenatal sFlt‐1/PlGF measurements taken ≥37 weeks' gestation were analyzed. sFlt‐1/PlGF ratio cut‐offs of <38, 38–110, 111–201 and >201 were tested against the following outcomes: birthweight ≤10th and ≤3rd centiles; operative delivery for suspected fetal welfare compromise; 5 min Apgar score; and neonatal admissions for extra care.
Results
Statistically significant associations were found between sFlt‐1/PlGF ratios 111–201 and birthweights ≤10th centile (p < 0.01, odds ratio [OR] 3.04, 95% confidence interval [CI] 1.52–6.10), and between operative delivery for suspected fetal welfare compromise and sFlt‐1/PlGF ratios 111–201 (p = 0.04, OR 2.21, 95% CI 1.03–4.75) and >201 (p = 0.01, OR 4.73, 95% CI 1.45–15.4).
Conclusions
This study indicates that maternal serum sFlt‐1/PlGF ratios performed at term may subsequently help identify significantly small‐for‐gestational age fetuses and operative delivery for suspected fetal welfare compromise. Further prospective studies may confirm these findings and substantiate the clinical importance of sFlt‐1/PlGF measurements in assisting the management of pregnancies at term.