Prognostic value of angiogenic markers in pregnant women with chronic hypertension

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JAHA.120.020631.pdf

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2021-09-07

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Binder, Julia
Palmrich, Pilar
Kalafat, Erkan
Pateisky, Petra
Oeztuerk, Ebru
Mittelberger, Johanna
Khalil, Asma

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Women with chronic hypertension face a 5-to 6-fold increased risk of developing preeclampsia compared with normotensive women. Angiogenic markers, especially soluble fms-like kinase 1 (sFlt-1) and placental growth factor (PlGF), were identified as clinically useful markers predicting the development of preeclampsia, but data on the prediction of superimposed preeclampsia are scarce. Therefore, we aimed to evaluate the predictive value of the sFlt-1/PlGF ratio for delivery because of superimposed preeclampsia in women with chronic hypertension. METHODS AND RESULTS: This retrospective study included 142 women with chronic hypertension and suspected superimposed preeclampsia. Twenty-seven women (19.0%) delivered because of maternal indications only, 17 women (12.0%) because of fetal indications primarily, and 98 women (69.0%) for other reasons. Women who both delivered because of maternal indications and for fetal indications had a significantly higher sFlt-1/PlGF ratio (median 99.9 and 120.2 versus 7.3, respectively, P<0.001 for both) and lower PlGF levels (median 73.6 and 53.3 versus 320.0 pg/mL, respectively, P<0.001 for both) compared with women who delivered for other reasons. SFlt-1/PlGF ratio and PlGF were strong predictors for delivery because of superimposed preeclampsia, whether for maternal or fetal indications (P<0.05). Half of women with angiogenic imbalance (sFlt-1/PlGF ratio ≥85 or PlGF levels <100 pg/mL) delivered because of maternal or fetal indications within 1.6 weeks (95% CI, 1.0–2.4 weeks). CONCLUSIONS: Angiogenic marker imbalance in women with suspected superimposed preeclampsia can predict delivery because of maternal and fetal indications related to superimposed preeclampsia and is associated with a significantly shorter time to delivery interval.

Subject Keywords

angiogenic markers, chronic hypertension, preeclampsia, superimposed preeclampsia, SUPERIMPOSED PREECLAMPSIA, SFLT-1PLGF RATIO, PREDICTIVE-VALUE, ONSET, RISK, Angiogenic markers, Chronic hypertension, Preeclampsia, Superimposed preeclampsia

URI

https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85115218908&origin=inward
https://hdl.handle.net/11511/94667

Journal

Journal of the American Heart Association

DOI

https://doi.org/10.1161/jaha.120.020631

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Department of Statistics, Article

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Angiogenic markers and their longitudinal change for predicting adverse outcomes in pregnant women with chronic hypertension Binder, Julia; Kalafat, Erkan; Palmrich, Pilar; Pateisky, Petra; Khalil, Asma (2021-09-01) Background: Women with chronic hypertension are at increased risk for adverse maternal and perinatal outcomes. Maternal serum angiogenic markers, such as soluble fms-like tyrosine kinase 1 and placental growth factor, can be used to triage women with suspected preeclampsia. However, data about these markers in pregnant women with chronic hypertension are scarce. Objective: We aimed to evaluate the predictive accuracy of maternal serum levels of soluble fms-like tyrosine kinase 1, placental growth factor, an...
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Citation Formats

J. Binder et al., “Prognostic value of angiogenic markers in pregnant women with chronic hypertension,” Journal of the American Heart Association, vol. 10, no. 17, pp. 0–0, 2021, Accessed: 00, 2021. [Online]. Available: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85115218908&origin=inward.