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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica

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Volume 42, Issue 1


The importance of repeated measurements of the sFlt-1/PlGF ratio for the prediction of preeclampsia and intrauterine growth restriction

Katharina Schoofs / Ulrike Grittner
  • Department for Biostatistics and Clinical Epidemiology, Charité University Medicine, Berlin, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Theresa Engels / Juliane Pape / Barbara Denk / Wolfgang Henrich / Stefan Verlohren
Published Online: 2013-08-09 | DOI: https://doi.org/10.1515/jpm-2013-0074


Aims: The sFlt-1/PlGF ratio has been evaluated as a diagnostic marker for preeclampsia (PE). The aim of this study was to explore the use of the sFlt-1/PlGF ratio as an aid in prediction for PE.

Methods: 150 patients with a high risk for PE were enrolled in this prospective study. Groups were compared according to the pregnancy outcome: controls (n=114), intrauterine growth restriction (IUGR) (n=14) and PE (n=22) with subclassification early PE<34 weeks (n=6). Measurements of sFlt-1 and PlGF were performed on the automated Elecsys system. Statistical comparison of the sFlt-1/PlGF ratio in different outcome groups and a mixed model analysis using random intercept models were performed.

Results: The sFlt-1/PlGF ratio was significantly higher in pregnancies complicated by PE up to 4 weeks before clinical diagnosis compared to controls (106.7±47.7 vs. 21.0±4.1; P=0.02). Levels of the sFlt-1/PlGF ratio were higher throughout pregnancy in women with IUGR compared to PE/control patients (intercept 1.57 vs. 1.30/0.67; P<0.05). The slope for the sFlt-1/PlGF ratio was significantly higher in PE and IUGR pregnancies compared to controls, indicating that a steep increase of the sFlt-1/PlGF ratio correlates with pathologic pregnancy outcomes.

Conclusion: The sFlt-1/PlGF ratio can identify pathologic pregnancy outcomes such as IUGR and PE before clinical diagnosis. Repeated measurements are necessary to assess the dynamics in serum values. The time-dependent slope of the sFlt-1/PlGF ratio is predictive for future pregnancy outcome and risk of developing preeclampsia.

Keywords: Angiogenic factors; biomarker; hypertension; IUGR; placental dysfunction; PlGF; prediction; preeclampsia; pregnancy; sFlt-1


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About the article

Corresponding author: Stefan Verlohren, Department of Obstetrics, Charité University Medicine, Berlin, Germany, E-mail:

Received: 2013-04-05

Accepted: 2013-07-08

Published Online: 2013-08-09

Published in Print: 2014-01-01

Citation Information: Journal of Perinatal Medicine, Volume 42, Issue 1, Pages 61–68, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2013-0074.

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