Association of sFlt-1 and C-reactive protein with outcomes in severe preeclampsia: A cohort study

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Biomarker Research

Background:

• Preeclampsia (PE) with severe features presents significant maternal and perinatal risks.
• Understanding the role of biomarkers like soluble FMS-like tyrosine kinase-1 (sFlt-1) and high-sensitivity C-reactive protein (hs-CRP) is crucial for predicting PE outcomes.

Purpose of the Study:

• To investigate the association between serum sFlt-1 and hs-CRP levels and maternal/perinatal outcomes in patients with preeclampsia with severe features.
• To evaluate the predictive capabilities of sFlt-1 and hs-CRP for adverse outcomes in severe preeclampsia.

Main Methods:

• A cohort study involving 100 third-trimester pregnant women (60 with PE, 40 controls).
• Serum sFlt-1 and hs-CRP levels were measured alongside clinical and epidemiological data.
• Hierarchical multiple regression and ROC curves were used to assess predictive abilities for adverse outcomes.

Main Results:

• Patients with PE had significantly higher sFlt-1 levels, but hs-CRP levels were not significantly different compared to controls.
• Both sFlt-1 and hs-CRP showed reasonable predictive ability for composite adverse maternal outcomes, but were not correlated with each other.
• sFlt-1, but not hs-CRP, was strongly associated with lower birth weight and Apgar score < 7 at 5 minutes.

Conclusions:

• Elevated sFlt-1 levels are characteristic of preeclampsia with severe features.
• While both biomarkers can predict adverse maternal outcomes, they exhibit distinct associations with perinatal morbidity, suggesting different underlying pathophysiological mechanisms in PE.
• Maternal age, prior hypertension, sFlt-1, and hs-CRP are independently associated with adverse maternal outcomes in severe preeclampsia.