Objectives: Preeclampsia (PE) is a hypertensive multisystem disorder complicating 2–8% of pregnancies and contributing significantly to maternal and perinatal mortality. This study aimed to evaluate the predictive value of the serum soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) ratio for early detection and severity assessment of PE. Materials and Methods: A prospective longitudinal cohort study was conducted at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, over 20 months, enrolling 150 primigravida women (20– 36-week gestation) with clinical suspicion of PE. Blood samples were collected at 2 time points for sFlt-1 and PlGF analysis. The sFlt-1/PlGF ratio was assessed in relation to blood pressure, proteinuria, and other clinical parameters. Statistical analysis: Data were analyzed using Epi-Info 7.2. Student’s t -test compared means; Pearson’s correlation assessed associations between biomarkers and clinical variables. Repeated measures analysis of variance and Bonferroni post hoc tests assessed changes over time. Logistic regression evaluated predictive power, and receiver operating characteristic (ROC) curve analysis determined diagnostic accuracy. Results: Of 150 participants, 25 developed PE, with a mean gestational age of 32 weeks at diagnosis. The sFlt-1/PlGF ratio was significantly elevated at the first visit (47.97 vs. 3.52; P < 0.001) and increased further at follow-up (65.25 vs. 5.41; P < 0.001). ROC analysis showed excellent diagnostic accuracy at cut-offs of 21.35 and 35, with sensitivity (96%, 92%) and specificity (97.6%, 99.2%). Conclusions: Although PE was clinically diagnosed at a mean of 32 weeks, early elevation of the sFlt-1/PlGF ratio highlights its value in identifying PE before clinical deterioration. Serial measurement may enhance prenatal screening, risk stratification, and timely intervention.
Sangma et al. (Mon,) studied this question.