Course of the sFlt-1/PlGF ratio in fetal growth restriction and correlation with biometric measurements, feto-maternal Doppler parameters and time to delivery

Purpose The study aimed to assess the course of the soluble Fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio in pregnant women with fetal growth restriction (FGR) and to evaluate potential associations between the sFlt-1/PlGF ratio and feto-maternal Doppler parameters, fetal...

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Published in:	Archives of gynecology and obstetrics Vol. 305; no. 3; pp. 597 - 605
Main Authors:	Andrikos, A., Andrikos, D., Schmidt, B., Birdir, C., Kimmig, R., Gellhaus, A., Köninger, A.
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-03-2022 Springer Nature B.V
Subjects:	Biomarkers - blood Biometrics Biometry Birth weight Blood Endocrinology Female Fetal Growth Retardation - blood Fetal Growth Retardation - diagnostic imaging Fetuses Gynecology Hospitals Human Genetics Humans Maternal-Fetal Medicine Medicine Medicine & Public Health Obstetrics Obstetrics/Perinatology/Midwifery Pathology Placenta Placenta Growth Factor - blood Pregnancy Retrospective Studies Vascular endothelial growth factor Vascular Endothelial Growth Factor Receptor-1 - blood Veins & arteries Womens health sFlt-1/PlGF Feto-maternal Doppler parameters Time to delivery Soluble Fms-like tyrosine kinase 1 Placental growth factor Fetal growth restriction
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Summary:	Purpose The study aimed to assess the course of the soluble Fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio in pregnant women with fetal growth restriction (FGR) and to evaluate potential associations between the sFlt-1/PlGF ratio and feto-maternal Doppler parameters, fetal biometric measurements and the time between study inclusion and birth (“time to delivery”). Methods This was a retrospective longitudinal single center study including 52 FGR cases. The serum levels of sFlt-1 and PlGF were measured by using the BRAHMS Kryptor Compact PLUS. Fetal biometric and Doppler parameters, as well as the sFlt-1/PlGF ratio, were obtained both upon study inclusion and upon birth. Results Various associations between the levels of the biomarkers in maternal blood upon study inclusion and upon birth and sonographic parameters were observed in FGR cases: umbilical artery ( p < 0.01), uterine arteries ( p < 0.01), ductus venosus ( p < 0.05), cerebroplacental ratio (CPR) ( p < 0.01), femur length ( p < 0.01) and birth weight ( p < 0.01). The higher the sFlt-1/PlGF ratio upon study inclusion, the shorter the “time to delivery” ( p < 0.01). The multivariate regression analysis showed that the greater the daily percentage increase of the angiogenic markers, the shorter the “time to delivery” ( p < 0.01). Conclusion The fetal well-being, as measured by feto-maternal Doppler parameters such as CPR and the severity of the placental dysfunction, as measured by the urgency of birth and birth weight, is reflected by the level of the sFlt-1/PlGF ratio in the maternal serum. A rapid daily increase of the sFlt-1/PlGF ratio is significantly associated with the clinical progression of the disease.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0932-0067 1432-0711
DOI:	10.1007/s00404-021-06186-5