Real-world data on the clinical use of angiogenic factors in pregnancies with placental dysfunction.

Background In routine clinical practice, angiogenic factor measurement can facilitate prediction and diagnosis of preeclampsia and other manifestations of placental dysfunction (eg, intrauterine growth restriction). Objective This real-world data analysis investigated the utility of soluble fms-like tyrosine kinase-1 and placental growth factor for preeclampsia and placental dysfunction. Study Design Blood serum soluble fms-like tyrosine kinase-1 and placental growth factor were measured using Elecsys soluble fms-like tyrosine kinase-1 and placental growth factor immunoassays (cobas e analyzer; Roche Diagnostics). Overall, 283 unselected singleton pregnancies with ≥1 determination of soluble fms-like tyrosine kinase-1–to–placental growth factor ratio were included. Distribution of the ratio at admission was normal ( 85/110 [22.3%]). Overall, 15.5% had preeclampsia or hemolysis, elevated liver enzyme levels, and low platelet count, and 15.5% of women had intrauterine growth restriction. Results Increasing soluble fms-like tyrosine kinase-1–to–placental growth factor ratio was associated with an increase in priority of delivery (r=0.38; P Conclusions Confirming the results of prospective studies, we observed a positive correlation between soluble fms-like tyrosine kinase-1–to–placental growth factor ratio and severity of placental dysfunction and a negative association with time to delivery. In a real-world setting, the soluble fms-like tyrosine kinase-1–placental growth factor ratio stratifies patients with normal outcome and outcome complicated by placental dysfunction.