Predictive Value Of Serum SFlt-1/PLGF Levels In Cases With High-risk Factors For Preeclampsia

Objective We measured serum soluble fms-like tyrosine kinase-1 and placental growth factor levels in pregnant women with risk factors for preeclampsia,and constructed a PE prediction model based on serum s Flt-1,PLGF levels and risk factors,and explored the predictive value of different models for the occurrence of early-onset preeclampsia and late-onset preeclampsia in this population,in order to provide a data reference basis for clinical improvement of PE prediction.Methods Using the present study method,295 pregnant women with risk factors for PE who attended our hospital from December 2021 to December2022 were selected as study subjects,and their fasting blood specimens were collected from20 weeks to 27 weeks+6 days of gestation,and their serum s Flt-1 and PLGF levels were measured by electrochemiluminescence method.Their pregnancy outcomes were followed up,and 59 maternal cases with PE were set as the case group(Group A);Group A could be divided into 20 maternal cases in the EOPE group(Group A1)and 39 maternal cases in the LOPE group(Group A2)according to the time of onset;236 maternal cases without PE were set as the control group(Group B).The general conditions,reasons for enrollment and pregnancy outcomes of all study subjects were recorded.Results 1.age,sampling gestational week and chronic hypertensive disease did not differ among the three groups,and the differences were not statistically significant(P>0.05);pre-pregnancy BMI in the EOPE group and pre-pregnancy BMI in the LOPE group were higher than the pre-pregnancy BMI in the control group,and the incidence of twin pregnancies in the EOPE group was higher than that in the control group,and the differences were statistically significant(P<0.05);the incidence of twin pregnancies in the LOPE group was not different from that in the control group compared with the control group,and the difference was not statistically significant(P>0.05);compared with the control group,the incidence of PE history was higher in both the EOPE and LOPE groups,and the difference was statistically significant(P<0.05),and the incidence of gestational diabetes mellitus was higher in both the EOPE and LOPE groups,and the difference was statistically significant(P<0.05).2.Compared with the control group,the incidence of serum PLGF in both the EOPE and LOPE groups both had lower serum PLGF levels,and the difference was statistically significant(P<0.05);the difference between the serum PLGF levels in the EOPE and LOPE groups was not statistically significant(P>0.05),but the serum PLGF levels in the EOPE group were reduced;the serum s Flt-1 and s Flt-1/PLGF levels in the EOPE and LOPE groups were both higher than those in the The differences were statistically significant(P<0.05);the differences in serum s Flt-1 and s Flt-1/PLGF levels between the EOPE and LOPE groups were not statistically significant(P>0.05),but serum s Flt-1 and s Flt-1/PLGF levels were slightly higher in the EOPE group.3.Serum s Flt-1/PLGF levels predict the AUC of EOPE in pregnant women with high risk factors for PE The AUC for predicting the occurrence of EOPE in pregnant women with risk factors for PE was 0.918,and the Jorden index was greatest at a cut-off value of 11.5,with a sensitivity of 95.0%and specificity of 77.5%,and its predictive efficacy was higher than that of using serum s Flt-1 and PLGF levels separately.4.The combination of high-risk factors and serum s Flt-1/PLGF levels constructed a model for predicting the occurrence of EOPE in pregnant women with high-risk factors for PE The probability prediction model of EOPE P=e~y/(1+e~y),Y=-46.223+1.259(pre-pregnancy BMI)+3.134(history of PE)+2.662(twin pregnancy)+3.021(GDM)+0.549(s Flt-1/PLGF),had an AUC of 0.973,a sensitivity of100.0%,a specificity of The predictive efficacy was higher than that of the prediction model constructed by combining serum s Flt-1 or PLGF levels with high-risk factors.5.The AUC of serum s Flt-1/PLGF levels for predicting LOPE in pregnant women with high-risk factors for PE was 0.799,and the Jorden index was greatest at a cut-off value of 11.11,with a sensitivity of 82.1%and a specificity of 72.9%.Its predictive efficacy was higher than that of using serum s Flt-1 and PLGF levels separately.6.High-risk factors combined with serum s Flt-1/PLGF levels to construct a probability prediction model for the occurrence of LOPE in pregnant women with high-risk factors for PE P=e~y/(1+e~y),Y=-12.705+0.271(pre-pregnancy BMI)+1.727(history of PE)+1.686(GDM)+0.256(s Flt-1/PLGF),which had an AUC of0.821,sensitivity of 61.54%,and specificity of 89.41%,and its predictive efficacy was higher than that of the prediction model constructed by combining serum s Flt-1 or PLGF levels with high-risk factors.7.Prediction model of high-risk factors combined with serum s Flt-1/PLGF levels predicted The predictive value of EOPE and LOPE in pregnant women with risk factors for PE was higher than that of s Flt-1/PLGF alone,and the difference was statistically significant(P<0.05).Conclusions 1.serum s Flt-1 and PLGF levels were correlated with PE,and elevated serum s Flt-1 and s Flt-1/PLGF levels and decreased PLGF levels were involved in the development of PE.2.for the development of EOPE or LOPE in pregnant women with high-risk factors for PE,the predictive model of serum s Flt-1/PLGF levels combined with high-risk from 20 weeks to 27 weeks+6 days of gestation For women with risk factors for PE,the predictive value of a predictive model combining serum s Flt-1/PLGF levels with high-risk factors is higher than that of a predictive model relying on serum s Flt-1,PLGF,s Flt-1/PLGF levels alone or a predictive model combining high-risk factors with serum s Flt-1and PLGF levels alone.3.For pregnant women with high risk factors for PE,further measurement of serum s Flt-1/PLGF levels after 20 weeks of gestation is recommended to assess their The possibility of future PE and guiding clinicians to reasonably triage pregnant women with high-risk factors for PE and optimize the management of pregnant women with high-risk factors for PE are important for early detection,early intervention,and avoidance of adverse outcomes.