The sFlt1/PlGF ratio predicts faster fetal deterioration in early fetal growth restriction

Detalhes bibliográficos
Autor(a) principal: Palma dos Reis, Catarina R.
Data de Publicação: 2023
Outros Autores: Brás, Sofia, Meneses, Tânia, Cerdeira, Ana S., Vatish, Manu, Martins, Ana T.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/151586
Resumo: Funding Information: Catarina R. Palma dos Reis acknowledges support from a Clarendon Fund Scholarship. Publisher Copyright: © 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).
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spelling The sFlt1/PlGF ratio predicts faster fetal deterioration in early fetal growth restrictionA historical cohort studyfetal deteriorationfetal growth restrictionsFlt1/PlGF ratioObstetrics and GynaecologyFunding Information: Catarina R. Palma dos Reis acknowledges support from a Clarendon Fund Scholarship. Publisher Copyright: © 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).Introduction: The velocity of fetal deterioration in fetal growth restriction is extremely variable, which makes monitoring and counseling very challenging. The soluble fms-like tyrosine kinase to placental growth factor (sFlt1/PlGF) ratio provides a readout of the vasoactive environment that correlates with preeclampsia and fetal growth restriction and that could be useful to predict fetal deterioration. Previous studies showed a correlation between higher sFlt1/PlGF ratios and lower gestational ages at birth, although it is unclear whether this is due to the increased incidence of preeclampsia. Our goal was to evaluate whether the sFlt1/PlGF ratio predicts faster fetal deterioration in early fetal growth restriction. Material and methods: This was a historical cohort study in a tertiary maternity hospital. Data from singleton pregnancies with early fetal growth restriction (diagnosed before 32 gestational weeks) confirmed after birth monitored between January 2016 and December 2020 were retrieved from clinical files. Cases of chromosomal/fetal abnormalities, infection and medical terminations of pregnancy were excluded. The sFlt1/PlGF ratio was acquired at diagnosis of early fetal growth restriction in our unit. The correlation of log10 sFlt1/PlGF with latency to delivery/fetal demise was assessed with linear, logistic (positive sFlt1/PlGF if >85) and Cox regression excluding deliveries for maternal conditions and controlling for preeclampsia, gestational age at time of ratio test, maternal age and smoking during pregnancy. Receiver-operating characteristic (ROC) analysis tested the performance of sFlt1/PlGF ratio in predicting delivery for fetal reasons in the following week. Results: 125 patients were included. Mean sFlt1/PlGF ratio was 91.2 (SD 148.7) and 28% of patients had a positive ratio. A higher log10 sFlt1/PlGF ratio predicted shorter latency for delivery/fetal demise in linear regression after controlling for confounders, β = −3.001, (−3.713 to −2.288). Logistic regression with ratio positivity confirmed these findings (latency for delivery 5.7 ± 3.32 weeks for ratios ≤85 vs 1.9 ± 1.52 weeks for ratios >85); β = −0.698 (−1.064 to −0.332). Adjusted Cox regression showed that a positive ratio confers a significantly positive hazard ratio (HR) for earlier delivery/fetal demise, HR 9.869 (5.061–19.243). ROC analysis showed an area under the curve of 0.847 (SE ± 0.06). Conclusions: sFlt1/PlGF ratio is correlated with faster fetal deterioration in early fetal growth restriction, independently of preeclampsia.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNPalma dos Reis, Catarina R.Brás, SofiaMeneses, TâniaCerdeira, Ana S.Vatish, ManuMartins, Ana T.2023-04-04T22:18:42Z20232023-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/151586eng0001-6349PURE: 57556572https://doi.org/10.1111/aogs.14546info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:34:02Zoai:run.unl.pt:10362/151586Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:54:38.894479Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv The sFlt1/PlGF ratio predicts faster fetal deterioration in early fetal growth restriction
A historical cohort study
title The sFlt1/PlGF ratio predicts faster fetal deterioration in early fetal growth restriction
spellingShingle The sFlt1/PlGF ratio predicts faster fetal deterioration in early fetal growth restriction
Palma dos Reis, Catarina R.
fetal deterioration
fetal growth restriction
sFlt1/PlGF ratio
Obstetrics and Gynaecology
title_short The sFlt1/PlGF ratio predicts faster fetal deterioration in early fetal growth restriction
title_full The sFlt1/PlGF ratio predicts faster fetal deterioration in early fetal growth restriction
title_fullStr The sFlt1/PlGF ratio predicts faster fetal deterioration in early fetal growth restriction
title_full_unstemmed The sFlt1/PlGF ratio predicts faster fetal deterioration in early fetal growth restriction
title_sort The sFlt1/PlGF ratio predicts faster fetal deterioration in early fetal growth restriction
author Palma dos Reis, Catarina R.
author_facet Palma dos Reis, Catarina R.
Brás, Sofia
Meneses, Tânia
Cerdeira, Ana S.
Vatish, Manu
Martins, Ana T.
author_role author
author2 Brás, Sofia
Meneses, Tânia
Cerdeira, Ana S.
Vatish, Manu
Martins, Ana T.
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
RUN
dc.contributor.author.fl_str_mv Palma dos Reis, Catarina R.
Brás, Sofia
Meneses, Tânia
Cerdeira, Ana S.
Vatish, Manu
Martins, Ana T.
dc.subject.por.fl_str_mv fetal deterioration
fetal growth restriction
sFlt1/PlGF ratio
Obstetrics and Gynaecology
topic fetal deterioration
fetal growth restriction
sFlt1/PlGF ratio
Obstetrics and Gynaecology
description Funding Information: Catarina R. Palma dos Reis acknowledges support from a Clarendon Fund Scholarship. Publisher Copyright: © 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).
publishDate 2023
dc.date.none.fl_str_mv 2023-04-04T22:18:42Z
2023
2023-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/151586
url http://hdl.handle.net/10362/151586
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 0001-6349
PURE: 57556572
https://doi.org/10.1111/aogs.14546
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
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