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The sFLT-1/PlGF Ratio for the Prediction of Preeclampsia-Related Adverse Fetal and Maternal Outcomes in Women with Preexisting Diabetes

  • Maternal Fetal Medicine/Biology: Original Article
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Abstract

To evaluate the predictive value of the sFlt-1/PlGF ratio for the prediction of preeclampsia in women with preexisting diabetes mellitus. This is a monocentric retrospective observational study conducted between January 2018 and December 2020. All singleton pregnancies with preexisting diabetes mellitus, who had a dosage of the sFlt-1/PlGF ratio between 30 and 34 + 6 weeks of gestation were included. The principal outcome was preeclampsia. The secondary outcomes were preterm preeclampsia, gestational hypertension, placental abruption, intrauterine fetal death, IUGR, small for gestational age and a composite outcome named “hypertensive disorder of pregnancy” including gestational hypertension, preeclampsia and HELLP syndrome (hemolysis, elevated liver enzymes and low platelet count). Of 63 patients, 22% presented preeclampsia. The area under the curve of sFlt-1/PlGF ratio was 0.90 (95% CI: 0.79–0.96) for the prediction of preeclampsia. The receiver operator characteristic analysis suggested that the optimal sFlt-1/PlGF cutoff to predict preeclampsia was 29, with a sensitivity of 86% (95% CI: 60.1–96.0) and a specificity of 92% (95% CI: 80.8–96.8). A cut-off of 38 provided a sensitivity of 71% (95% CI: 45.4–88.3), a specificity of 92% (95% CI: 80.8–96.8). Further analysis using multivariable methods revealed nephropathy was significantly associated with PE (p = 0.014). The use of the sFlt-1/PlGF ratio during the third trimester of pregnancy seems to be of interest as a prognostic tool to improve multidisciplinary management of patients with preexisting diabetes mellitus.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Paule de Viguier maternity, CHU Toulouse, 330 avenue de Grande-Bretagne, 70034 31059, Toulouse, TSA, France

    Anais Provendier, Federico Migliorelli, Lola Loussert, Béatrice Guyard Boileau, Christophe Vayssiere, Ninon Dupuis & Paul Guerby

  2. Department of Biochemistry and Hormonology, University Paul Sabatier, Toulouse, France

    Safouane M. Hamdi

  3. Department of Endocrinology and Diabetology, University Paul Sabatier, Toulouse, France

    Hélène Hanaire

  4. Toulouse Institute for Infectious and Inflammatory Diseases, Inserm UMR 1291 - CNRS UMR 5051– University Toulouse III, Toulouse, France

    Paul Guerby

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  1. Anais Provendier
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  2. Federico Migliorelli
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  4. Béatrice Guyard Boileau
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  6. Safouane M. Hamdi
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  7. Hélène Hanaire
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  8. Ninon Dupuis
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  9. Paul Guerby
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Contributions

PROVENDIER Anais, MIGLIORELLI Federico and GUERBY Paul analyzed data and wrote the manuscript. PROVENDIER Anais, GUYARD BOILEAU Beatrice, VAYSSIERE Christophe, M. HAMDI Safouane and DUPUIS Ninon collected data. LOUSSERT Lola and HANAIRE Helene reviewed the manuscript. PROVENDIER Anais and GUERBY Paul coordinated and designed research and edited the manuscript. GUERBY Paul is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Correspondence to Paul Guerby.

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Provendier, A., Migliorelli, F., Loussert, L. et al. The sFLT-1/PlGF Ratio for the Prediction of Preeclampsia-Related Adverse Fetal and Maternal Outcomes in Women with Preexisting Diabetes. Reprod. Sci. (2024). https://doi.org/10.1007/s43032-024-01540-9

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