Angiogenic Markers Predict Pregnancy Complications and Prolongation in Preeclampsia Continuous Versus Cutoff Values
| Autor: | Hans J. Versendaal, Anton H. van den Meiracker, Yvonne Vergouwe, Eric A.P. Steegers, Willy Visser, A.H. Jan Danser, Henk Russcher, Koen Verdonk, Langeza Saleh, Henk A. Bremer |
|---|---|
| Přispěvatelé: | Internal Medicine, Obstetrics & Gynecology, Public Health, Clinical Chemistry |
| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Gestational Age 030204 cardiovascular system & hematology Preeclampsia 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Pre-Eclampsia Predictive Value of Tests Pregnancy Risk Factors Internal Medicine medicine Humans Netherlands Placenta Growth Factor Creatinine 030219 obstetrics & reproductive medicine Proteinuria Vascular Endothelial Growth Factor Receptor-1 biology Obstetrics business.industry Gestational age Reproducibility of Results Middle Aged medicine.disease Prognosis Surgery Blood pressure chemistry Alanine transaminase biology.protein Gestation Female medicine.symptom business |
| Zdroj: | Hypertension, 70(5), 1025-+. Lippincott Williams & Wilkins |
| ISSN: | 1524-4563 0194-911X |
| Popis: | To assess the incremental value of a single determination of the serum levels of sFlt-1 (soluble Fms-like tyrosine kinase 1) and PlGF (placental growth factor) or their ratio, without using cutoff values, for the prediction of maternal and fetal/neonatal complications and pregnancy prolongation, 620 women with suspected/confirmed preeclampsia, aged 18 to 48 years, were included in a prospective, multicenter, observational cohort study. Women had singleton pregnancies and a median pregnancy duration of 34 (range, 20–41) weeks. Complications occurred in 118 women and 248 fetuses. The median duration between admission and delivery was 12 days. To predict prolongation, PlGF showed the highest incremental value ( R 2 =0.72) on top of traditional predictors (gestational age at inclusion, diastolic blood pressure, proteinuria, creatinine, uric acid, alanine transaminase, lactate dehydrogenase, and platelets) compared with R 2 =0.53 for the traditional predictors only. The sFlt-1/PlGF ratio showed the highest value to discriminate women with and without maternal complications (C-index=0.80 versus 0.63 for the traditional predictors only), and to discriminate fetal/neonatal complications (C-index=0.86 versus 0.78 for the traditional predictors only). Applying previously suggested cutoff values for the sFlt-1/PlGF ratio yielded lower incremental values than applying continuous values. In conclusion, sFlt-1 and PlGF are strong and independent predictors for days until delivery along with maternal and fetal/neonatal complications on top of the traditional criteria. Their use as continuous variables (instead of applying cutoff values for different gestational ages) should now be tested in a prospective manner, making use of an algorithm calculating the risk of an individual woman with suspected/confirmed preeclampsia to develop complications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|