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December 8, 2025Open Access

Angiogenic Biomarkers and Neonatal Outcomes in Suspected Preeclampsia: Retrospective Cohort Study

Puntos clave

Elevated sFlt-1/PlGF ratio correlates with adverse neonatal outcomes, including complications with growth.
Logistic regression analysis shows aOR for feeding intolerance is 3.03 and for small-for-gestational age is 2.52.
Retrospective cohort study encompasses 162 singleton neonates from high-risk pregnancies due to suspected preeclampsia.
Findings highlight the need for risk assessment in pregnancy to manage neonatal health outcomes effectively.

Resumen

ABSTRACT Placental growth factor (PlGF) and soluble fms‐like tyrosine kinase 1 (sFlt1) are two biomarkers associated with placental function and the sFlt‐1/PlGF ratio is frequently used for risk assessment and prediction of preeclampsia in pregnancy. Objective To assess the association between elevated sFlt‐1/PlGF ratio and adverse neonatal outcomes in pregnancies with suspected preeclampsia. Design Retrospective cohort study. Setting A tertiary centre in Hong Kong. Population 162 singleton neonates delivered between January 2020 and May 2023 from pregnancies complicated by suspected preeclampsia and sFlt‐1/PlGF taken within 4 weeks before delivery. Methods Pregnant women with suspected preeclampsia were recruited with analysis of serum Flt‐1 and PlGF. Neonatal outcomes were compared between neonates from pregnancies with sFlt‐1/PlGF ratio ≥ 85 (high‐risk group) and < 85 (low‐risk group). Main Outcome Measures Neonatal outcomes including growth, respiratory, gastrointestinal, and metabolic complications. Results Logistic regression analysis showed that after adjustment for gestational age, preeclampsia and newborn sex, sFlt‐1/PlGF ratio ≥ 85 was significantly associated with small‐for‐gestation (SGA; aOR = 2.52, 95% C.I. = 1.12–5.60), feeding intolerance (aOR = 3.03, 95% C.I. = 1.01–9.09), need for parenteral nutrition (PN; aOR = 11.19, 95% C.I. = 2.23–56.29), prolonged PN (aOR = 6.92, 95% C.I. = 1.43–33.39), hospitalisation over 7 and 30 days (aOR = 3.62, 95% C.I. = 1.20–10.87 and aOR = 7.04, 95% C.I. = 1.08–45.80 respectively). Linear regression showed a significant association between sFlt‐1/PlGF ratio and duration of respiratory support, PN and duration of hospital stay. Conclusions An elevated maternal sFlt‐1/PlGF ratio within 4 weeks of delivery is significantly associated with adverse neonatal outcomes including SGA, gastrointestinal complications, prolonged parenteral nutrition and prolonged hospitalisation.

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