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Dual-cutoff of sFlt-1/PlGF ratio in the stratification of preeclampsia: a systematic review and meta-analysis

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Abstract

Purpose

To systematically review the approach of using two independent sFlt-1/PlGF cutoffs that has better sensitivity (cutoff-sen) and specificity (cutoff-spe) separately for risk stratification in the detection of preeclampsia.

Methods

PubMed and Embase databases and reference lists were searched up to June 2016. Inclusion criteria were blood samples for sFlt-1/PlGF with separate cutoffs (cutoff-sen and cutoff-spe) provided. Six relevant studies were identified. Pooling of results was done based on three studies and a systematic review was performed based on all six.

Results

The strategy of using a cutoff of ≤33 and ≥85 for early onset preeclampsia, and ≤33 and ≥110 for the late onset preeclampsia was proposed and examined. The pooled sensitivity for cutoff-sen was: 95.3% (90.6–98.1%) and 88.6% (82.9–92.9%) for early and late onset preeclampsia, respectively. The pooled specificity for cutoff-spe was: 97.6% (95.2–98.9%) and 94.2% (91.4–96.3%) for early and late onset preeclampsia respectively. The pooled estimation of the early onset pre-eclamptic pregnancies and control normal pregnancies classified in the equivocal zone was 4.9% (2.0–8.8%) and 32.4% (25.7–39.5%), respectively, and 26.8% (10.3–47.6%) and 8.7% (3.0–17.6%) for late onset patients.

Conclusion

The new dual-cutoff diagnostic system optimizes the predictive performance of the single cutoff system. Further studies are required to assess the performance of this system and to define the approach and frequency at which subjects in the equivocal zone should be screened.

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Author notes

    Authors and Affiliations

    1. Department of Obstetrics and Gynecology, Beijng Chao-yang Hospital, Capital Medical University, Beijing, 100020, People’s Republic of China

      Mutong Zhao, Zhiqing Zhu, Chongdong Liu & Zhenyu Zhang

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    1. Mutong Zhao
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    2. Zhiqing Zhu
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    3. Chongdong Liu
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    4. Zhenyu Zhang
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    Correspondence to Zhenyu Zhang.

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    The authors declare that they have no conflict of interest.

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    This article does not contain any studies with human participants or animals performed by any of the authors.

    Additional information

    M. Zhao and Z. Zhu are contributed equally to the work.

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    Zhao, M., Zhu, Z., Liu, C. et al. Dual-cutoff of sFlt-1/PlGF ratio in the stratification of preeclampsia: a systematic review and meta-analysis. Arch Gynecol Obstet 295, 1079–1087 (2017). https://doi.org/10.1007/s00404-017-4302-3

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    • DOI: https://doi.org/10.1007/s00404-017-4302-3

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