Predictive and prognostic performance of sFlt-1/PlGF ratio for preeclampsia in women with singleton pregnancy in a tertiary care institution in Mexico

Background: Preeclampsia is a complex hypertensive disorder of pregnancy characterized by placental dysfunction and maternal multiorgan injury. Circulating angiogenic and antiangiogenic biomarkers may improve risk stratification and prediction of adverse outcomes. Methods: This retrospective cohort study evaluated the predictive and prognostic performance of the soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) ratio in patients with singleton pregnancy from 24 to 36 + 6 weeks who had clinical or biochemical suspicion of preeclampsia. The sFlt-1/PlGF ratio was calculated from maternal serum concentrations measurements of both biomarkers in 144 women at the Hospital of Gynecology and Obstetrics, Unidad Medica de Alta Especialidad, Centro Medico Nacional de Occidente in Guadalajara, Jalisco, Mexico from April 2024-January 2026. Results: Among 144 women included in the final analysis, 57 (39.5%) developed preeclampsia; 39 (68.4%) had early-onset and 18 (31.6%) late-onset preeclampsia. The median sFlt-1/PlGF ratio was higher in women who developed the disease than in those in the control group (98.65 vs 11.86; p<0.001). The diagnostic performance of the sFlt-1/PlGF ratio using a cut-off value≥38 to predict preeclampsia yielded a sensitivity of 73.68% (95% CI: 61.02-83.35) and specificity of 81.61% (95% CI: 72.19-88.35). Higher sFlt-1/PlGF ratios were also observed among pregnancies with adverse maternal or perinatal outcomes. Conclusions: The sFlt-1/PlGF ratio demonstrated good discriminatory performance for preeclampsia and association with adverse maternal and perinatal outcomes in our cohort. The sFlt-1/PlGF ratio correlates accurately with prognostic value.