Non-angiogenic preeclampsia (sFlt1/PlGF ratio <85) was associated with a significantly lower rate of preterm delivery <34 weeks compared to angiogenic preeclampsia (8.7% vs 64.7%, p<0.0001).
Cohort (n=97)
Does a normal angiogenic profile (sFlt1/PlGF ratio <85) predict a lower risk of adverse outcomes in women with preeclampsia compared to an abnormal profile?
Non-angiogenic preeclampsia (sFlt1/PlGF ratio <85) is associated with a significantly lower risk of severe adverse outcomes and extreme prematurity compared to the angiogenic form.
Absolute Event Rate: 8.7% vs 64.7%
p-value: p=<0.0001
OBJECTIVE: To compare the clinical characteristics and outcomes of preeclamptic women presenting with a normal plasma angiogenic profile with those subjects who are characterized by an abnormal angiogenic profile. METHODS: This was a secondary analysis of a prospective cohort study in women presenting to obstetrical triage at <37 weeks of gestation and diagnosed with preeclampsia within 2 weeks of enrollment and in whom angiogenic factors (sFlt1 and PlGF) measurements were available. Patients were divided into two groups based on their circulating levels of these factors described as a ratio; the sFlt1/PlGF ratio, non-angiogenic preeclampsia (sFlt1/PlGF ratio <85) and angiogenic preeclampsia (sFlt1/PlGF ratio ≥85). The data are presented by sFlt1/PlGF category using median and quartile 1-quartile 3 for continuous variables and by frequency and sample sizes for categorical variables. RESULTS: In our cohort, the patients with non-angiogenic preeclampsia (N = 46) were more obese BMI: 35.2 (31.6, 38.7) versus 31.1 (28.0, 39.0), p = 0.04, more likely to have preexisting diabetes (21.7% versus 2.0%, p = 0.002) and presented at a later gestational age 35 (32, 37) versus 32 (29, 34) weeks, p < 0.0001 as compared with women with angiogenic preeclampsia (N = 51). Women with non-angiogenic preeclampsia had no serious adverse outcomes (elevated liver function tests/low platelets: 0% versus 23.5%, abruption: 0% versus 9.8%, pulmonary edema: 0% versus 3.9%, eclampsia: 0% versus 2.0 %, small for gestational age: 0% versus 17.7% and fetal/neonatal death: 0% versus 5.9%) as compared with women with angiogenic preeclampsia. The rate of preterm delivery <34 weeks was 8.7% in non-angiogenic preeclampsia compared with 64.7% in angiogenic preeclampsia (p < 0.0001). Interestingly, delivery between 34 and 37 weeks and resource utilization (hospital admission days) were similar in the two groups. CONCLUSION: In contrast to the angiogenic form, the non-angiogenic form of preeclampsia is characterized by little to no risk of preeclampsia-related adverse outcomes, other than iatrogenic prematurity. Incorporation of angiogenic biomarkers in the evaluation of preeclampsia may allow accurate and early identification of severe disease.
Rana et al. (Wed,) conducted a cohort in Preeclampsia (n=97). Non-angiogenic preeclampsia (sFlt1/PlGF ratio <85) vs. Angiogenic preeclampsia (sFlt1/PlGF ratio ≥85) was evaluated on Preterm delivery <34 weeks (p=<0.0001). Non-angiogenic preeclampsia (sFlt1/PlGF ratio <85) was associated with a significantly lower rate of preterm delivery <34 weeks compared to angiogenic preeclampsia (8.7% vs 64.7%, p<0.0001).