Elevated mid-pregnancy plasma ratio of sFlt1/PlGF in women prior to the development of preeclampsia

Objective To evaluate whether the sFlt1/PlGF ratio is increased in mid-pregnancy in women developing preeclampsia later. Methods A case-control study was conducted in Department of Gynecology and Obstetrics at Women and Children' s Hospital of Ningbo University. We included 56 women during 24–26 gestational weeks who developed preeclampsia later (cases) and 268 women with uncomplicated pregnancy (controls). The concentrations of sFlt-1 and PlGF were measured with commercially available ELISA kits during 24–28 gestational weeks. Logistic regression was employed to model the relationship between selected biomarkers and the occurrence of preeclampsia. Results The mean sFlt-1/PlGF ratio during mid-pregnancy was 22.95 among patients with preeclampsia, significantly higher than that observed in the control group (mean 14.87; P < 0.001). In logistic regression analysis, the sFlt-1/PlGF ratio was positively associated with the occurrence of preeclampsia (adjusted OR 1.051, 95% CI 1.022–1.081; P = 0.001). The discriminative ability of the model was moderate, with an area under the receiver operating characteristic curve of 0.730 (95% CI 0.644–0.795). Conclusions The sFlt1/PlGF ratio is increased at mid-pregnancy in women developing preeclampsia later. Our study provides additional evidence supporting sFlt1/PlGF ratio as a predictive biomarker of preeclampsia.