IJCEMR

Article http://dx.doi.org/10.26855/ijcemr.2024.04.004

Assessing the Prognostic Value of Serum PLGF, sFlt-1, and sFlt-1/PLGF Ratios in Predicting Adverse Pregnancy Outcomes in Preeclampsia: A Comprehensive Analysis

TOTAL VIEWS: 250

Min Liu1, Weicong Liang3, Yitong Lu2, Yanqin Liu2, Meng Li2, Xinwen Zhang2,*

1Second Clinical Medical College, Shaanxi University of Traditional Chinese Medicine, Xianyang, Shaanxi, China.

2Department of Women's Health, Xi'an People's Hospital, Xi'an, Shaanxi, China.

3Xi'an Medical University, Xi'an, Shaanxi, China.

*Corresponding author: Xinwen Zhang

Published: May 21,2024

Abstract

Objective: This study investigates the correlation between serum levels of placental growth factor (PLGF), soluble FMS-like tyrosine kinase-1 (sFlt-1), and the sFlt-1/PLGF ratio, and adverse pregnancy outcomes in preeclampsia (PE) patients. Methods: We analyzed data from 1,383 pregnant women diagnosed with preeclampsia at Xi'an People's Hospital (No. 4 Hospital of Xi'an) from July 2022 to June 2023. The participants were categorized into a PE group of 95 individuals, further divided into 53 with mild preeclampsia (mPE) and 42 with severe preeclampsia (sPE), and a control group of 1,288 individuals. The PE group was also subdivided based on pregnancy outcomes into a poor outcome subgroup (367 cases) and a normal delivery subgroup (1,015 cases). Serum PLGF, sFlt-1, and sFlt-1/PLGF levels were measured and analyzed in relation to pregnancy outcomes. Results: The PE group exhibited significantly lower PLGF levels and higher sFlt-1 and sFlt-1/PLGF levels compared to the control group. Within the PE group, the sPE subgroup had significantly lower PLGF and higher sFlt-1/PLGF levels than the mPE subgroup. Patients with adverse outcomes showed significantly higher sFlt-1 and sFlt-1/PLGF levels compared to those with normal delivery outcomes. Spearman correlation analysis indicated a negative correlation between PLGF levels and adverse pregnancy outcomes (ρ = -0.057, P < 0.05), and a positive correlation of sFlt-1 and sFlt-1/PLGF levels with adverse outcomes (ρ = 0.075 and 0.082, respectively; both P < 0.01). Conclusion: Lower serum PLGF and higher sFlt-1 and sFlt-1/PLGF levels are significantly associated with PE and adverse pregnancy outcomes, underscoring their potential as biomarkers for predicting pregnancy complications in PE patients.

References

[1] Jena MK, Sharma NR, Petitt M, Maulik D, Nayak NR. (2020). Pathogenesis of Preeclampsia and Therapeutic Approaches Targeting the Placenta. Biomolecules, 10. https://doi.org/10.3390/biom10060953.

[2] Gil-Acevedo LA, Ceballos G, Torres-Ramos YD. (2022). Foetal lipoprotein oxidation and preeclampsia. Lipids in Health and Disease, 21:51. https://doi.org/10.1186/s12944-022-01663-5.

[3] Poon LC, Shennan A, Hyett JA, Kapur A, Hadar E, Divakar H, McAuliffe F, da Silva Costa F, von Dadelszen P, McIntyre HD, Kihara AB, Di Renzo GC, Romero R, D'Alton M, Berghella V, Nicolaides KH, Hod M. (2019). The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. International Journal of Gynaecology and Obstetrics: The official organ of the International Federation of Gynaecology and Obstetrics, 145 Suppl 1:1-33. https://doi.org/10.1002/ijgo.12802.

[4] Armaly Z, Zaher M, Knaneh S, Abassi Z. (2019). Preeclampsia: Pathogenesis and Mechanisms Based Therapeutic Approaches. Harefuah, 158:742-747,

[5] Osol G, Ko NL, Mandalà M, (2017), Altered Endothelial Nitric Oxide Signaling as a Paradigm for Maternal Vascular Maladaptation in Preeclampsia. Current Hypertension Reports, 19:82. https://doi.org/10.1007/s11906-017-0774-6.

[6] Erez O, Romero R, Jung E, Chaemsaithong P, Bosco M, Suksai M, Gallo DM, Gotsch F. (2022). Preeclampsia and eclampsia: the conceptual evolution of a syndrome. American Journal of Obstetrics and Gynecology, 226:S786-s803. https://doi.org/10. 1016/j.ajog.2021.12.001.

[7] Xiong J, Jin X, Xu K, Wu B, Xu Y, Ruan D, He X. (2022). LncRNA-loc391533 is involved in the progression of preeclampsia through VEGF. Ginekologia polska. https://doi.org/10.5603/GP.a2022.0056.

[8] Bokuda K, Ichihara A (2023) Preeclampsia up to date-What's going on? Hypertension research: Official journal of the Japanese Society of Hypertension, 46:1900-1907. https://doi.org/10.1038/s41440-023-01323-w.

[9] Ngene NC, Moodley J. (2018). Role of angiogenic factors in the pathogenesis and management of pre-eclampsia. International Journal of Gynaecology and Obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 141:5-13. https://doi.org/10.1002/ijgo.12424.

[10] Lee NMW, Chaemsaithong P, Poon LC. (2024). Prediction of preeclampsia in asymptomatic women. Best practice & research Clinical Obstetrics & Gynaecology, 92:102436. https://doi.org/10.1016/j.bpobgyn.2023.102436.

[11] Parchem JG, Kanasaki K, Kanasaki M, Sugimoto H, Xie L, Hamano Y, Lee SB, Gattone VH, Parry S, Strauss JF, Garovic VD, McElrath TF, Lu KH, Sibai BM, LeBleu VS, Carmeliet P, Kalluri R. (2018). Loss of placental growth factor ameliorates maternal hypertension and preeclampsia in mice. The Journal of Clinical Investigation, 128:5008-5017. https://doi.org/10.1172/jci99026.

[12] Zuo Q, Zou Y, Huang S, Wang T, Xu Y, Zhang T, Zhang M, Ge Z, Jiang Z. (2021). Aspirin reduces sFlt-1-mediated apoptosis of trophoblast cells in preeclampsia. Molecular Human Reproduction, 27. https://doi.org/10.1093/molehr/gaaa089.

[13] Wojcik M, Karouni F, Jindal S, Kapaya H. (2021). Implementing placental-growth-factor (PLGF) measurements in suspected pre-eclampsia—Challenges in clinical practice. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 266:157-162. https://doi.org/10.1016/j.ejogrb.2021.10.006.

[14] Hromadnikova I, Dvorakova L, Kotlabova K, Krofta L. (2019). The Prediction of Gestational Hypertension, Preeclampsia and Fetal Growth Restriction via the First Trimester Screening of Plasma Exosomal C19MC microRNAs. International Journal of Molecular Sciences, 20. https://doi.org/10.3390/ijms20122972.

[15] Savka RF, Mykolaiovych Berbets A, Mykhailovych Barbe A, Mykhailovych Yuzko O, Radu MR. (2023). Changes in concentrations of melatonin, PlGF, and cytokines in women with preeclampsia. Journal of Medicine and Life, 16:471-476. https://doi.org/10.25122/jml-2022-0283.

[16] Chang X, He Q, Wei M, Jia L, Wei Y, Bian Y, Duan T, Wang K (2023) Human umbilical cord mesenchymal stem cell derived exosomes (HUCMSC-exos) recovery soluble fms-like tyrosine kinase-1 (sFlt-1)-induced endothelial dysfunction in preeclampsia. European Journal of Medical Research, 28:277. https://doi.org/10.1186/s40001-023-01182-8.

[17] Huang X, Jia L, Jia Y, Xu X, Wang R, Wei M, Li H, Peng H, Wei Y, He Q, Wang K. (2023). sFlt-1-enriched exosomes induced endothelial cell dysfunction and a preeclampsia-like phenotype in mice. Cytokine, 166:156190. https://doi.org/10.1016/ j.cyto.2023.156190.

[18] Agrawal S, Cerdeira AS, Redman C, Vatish M. (2018). Meta-Analysis and Systematic Review to Assess the Role of Soluble FMS-Like Tyrosine Kinase-1 and Placenta Growth Factor Ratio in Prediction of Preeclampsia: The SaPPPhirE Study. Hypertension (Dallas, Tex: 1979), 71:306-316. https://doi.org/10.1161/hypertensionaha.117.10182.

[19] Dröge LA, Perschel FH, Stütz N, Gafron A, Frank L, Busjahn A, Henrich W, Verlohren S. (2021). Prediction of Preeclampsia-Related Adverse Outcomes With the sFlt-1 (Soluble fms-Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor)-Ratio in the Clinical Routine: A Real-World Study. Hypertension (Dallas, Tex: 1979), 77:461-471. https://doi.org/10.1161/hypertensionaha.120.15146.

[20] Nóbrega L, Katz L, Lippo L, Amorim MM. (2022). Association of sFlt-1 and C-reactive protein with outcomes in severe preeclampsia: A cohort study. Medicine, 101. https://doi.org/10.1097/md.0000000000029059.

[21] Tanaka H, Nagahashi Y, Toriyabe K, Maki S, Takakura S, Enomoto N, Tanaka K, Shinji K, Ikeda T. (2022). sFlt-1 value predicts pregnancy prolongation periods from diagnosis in pregnant women diagnosed with early-onset preeclampsia. The Journal of Ma-ternal-Fetal & Neonatal Medicine: The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet, 35:4196-4198. https://doi.org/10.1080/ 14767058.2020.1849093.

How to cite this paper

Assessing the Prognostic Value of Serum PLGF, sFlt-1, and sFlt-1/PLGF Ratios in Predicting Adverse Pregnancy Outcomes in Preeclampsia: A Comprehensive Analysis

How to cite this paper: Min Liu, Weicong Liang, Yitong Lu, Yanqin Liu, Meng Li, Xinwen Zhang. (2024) Assessing the Prognostic Value of Serum PLGF, sFlt-1, and sFlt-1/PLGF Ratios in Predicting Adverse Pregnancy Outcomes in Preeclampsia: A Comprehensive AnalysisInternational Journal of Clinical and Experimental Medicine Research8(2), 216-221.

DOI: http://dx.doi.org/10.26855/ijcemr.2024.04.004