Placental angiogenic biomarkers for triage of suspected preeclampsia and prediction of maternal and neonatal morbidity in a high-risk population

Objective Placental angiogenic biomarkers, including soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF), are used to predict preeclampsia (PE) and related adverse outcomes . This study aimed to assess differences in sFlt-1/PlGF ratios among high-risk women according to PE, maternal and neonatal morbidity, and to evaluate the predictive performance of thresholds > 38 and > 85, including time to delivery.Methods In this retrospective cohort study, 289 high-risk singleton pregnant women (2015−2019) were included. sFlt-1/PlGF ratios were measured after 24 weeks of gestation and compared across outcome groups.Results sFlt-1/PlGF ratios were significantly lower in the reference group compared to the confirmed and the suspected PE group. Ratios > 38 were associated with PE (OR 12.2 (95% CI 4.9−30.7; p < 0.001)), maternal morbidity (OR 22.5 (95% CI 8.9−56.7; p < 0.001)), neonatal morbidity (OR 4.0 (95% CI 2.0−8.0; p < 0.001)) and delivery within one, two, and three weeks (OR 20.0, 9.2, and 14.6; all p < 0.001).Conclusion The sFlt-1/PlGF ratio supports individualized management in high-risk pregnancies.