| Autor: |
Bian X; From the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China (X.B.)., Biswas A; Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore (A.B.)., Huang X; Department of Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang, China (X.H.)., Lee KJ; Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, South Korea (K.J.L.)., Li TK; Department of Obstetrics and Gynecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China (T.K.-T.L.)., Masuyama H; Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Japan (H.M.)., Ohkuchi A; Jichi Medical University Hospital, Tochigi, Japan (A.O.)., Park JS; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea (J.S.P.)., Saito S; University of Toyama, Toyama, Japan (S.S.)., Tan KH; Department of Obstetrics and Gynecology, KK Women's and Children's Hospital, Singapore (K.H.T., K.K.H.)., Yamamoto T; Department of Obstetrics and Gynecology, Nihon University Itabashi Hospital, Tokyo, Japan (T.Y.)., Dietl A; Roche Diagnostics GmbH, Penzberg, Germany (A.D., S.G.)., Grill S; Roche Diagnostics GmbH, Penzberg, Germany (A.D., S.G.)., Verhagen-Kamerbeek WDJ; Roche Diagnostics International Ltd, Rotkreuz, Switzerland (W.D.J.V.-K, M.H.)., Shim JY; Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea (J.-Y.S.)., Hund M; Roche Diagnostics International Ltd, Rotkreuz, Switzerland (W.D.J.V.-K, M.H.). |
| Abstrakt: |
Current diagnostic criteria have limited clinical value for prediction of preeclampsia and fetal adverse outcomes. The prediction of short-term outcome in pregnant women with suspected preeclampsia study in Asia (PROGNOSIS Asia) was a prospective, multicenter study designed to investigate the value of the sFlt-1 (soluble fms-like tyrosine kinase 1)/PlGF (placental growth factor) ratio for predicting adverse outcomes in pregnant Asian women with suspected preeclampsia. Seven hundred sixty-four pregnant women at gestational week 20+0 days (18+0 days in Japan) to 36+6 days were enrolled at 25 sites in Asia. The primary objectives were to demonstrate the value of the sFlt-1/PlGF ratio for ruling out preeclampsia within 1 week and ruling in preeclampsia within 4 weeks. The value of the ratio for predicting fetal adverse outcomes was also assessed. Seven hundred patients were evaluable for primary end point analysis. The prevalence of preeclampsia was 14.4%. An sFlt-1/PlGF ratio of ≤38 had a negative predictive value of 98.6% (95% CI, 97.2%-99.4%) for ruling out preeclampsia within 1 week, with 76.5% sensitivity and 82.1% specificity. The positive predictive value of a ratio of >38 for ruling in preeclampsia within 4 weeks was 30.3% (95% CI, 23.0%-38.5%), with 62.0% sensitivity and 83.9% specificity. An sFlt-1/PlGF ratio of ≤38 had a negative predictive value of 98.9% (95% CI, 97.6%-99.6%) for ruling out fetal adverse outcomes within 1 week and a ratio of >38 had a positive predictive value of 53.5% (95% CI, 45.0%-61.8%) for ruling in fetal adverse outcomes within 4 weeks. The sFlt-1/PlGF ratio cutoff of 38 demonstrated clinical value for the short-term prediction of preeclampsia in Asian women with suspected preeclampsia, potentially helping to prevent unnecessary hospitalization and intervention. |
