Angiogenic Biomarkers and Neonatal Outcomes in Suspected Preeclampsia: Retrospective Cohort Study

Area of Science:

• Perinatal medicine
• Maternal-fetal medicine
• Neonatalogy

Background:

• Placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt1) are key biomarkers of placental function.
• The sFlt-1/PlGF ratio is utilized for preeclampsia risk assessment during pregnancy.

Purpose of the Study:

• To investigate the association between an elevated sFlt-1/PlGF ratio and adverse neonatal outcomes in pregnancies with suspected preeclampsia.

Main Methods:

• A retrospective cohort study was conducted involving 162 neonates from pregnancies with suspected preeclampsia at a Hong Kong tertiary center.
• Maternal serum sFlt-1 and PlGF levels were analyzed within 4 weeks of delivery.
• Neonatal outcomes were compared between high-risk (sFlt-1/PlGF ratio ≥ 85) and low-risk (< 85) groups.

Main Results:

• Elevated sFlt-1/PlGF ratio (≥ 85) was significantly associated with small-for-gestation (SGA) infants (aOR=2.52) and feeding intolerance (aOR=3.03).
• High-risk pregnancies showed increased odds for needing parenteral nutrition (PN) (aOR=11.19), prolonged PN (aOR=6.92), and extended hospital stays (≥7 days: aOR=3.62; ≥30 days: aOR=7.04).
• The sFlt-1/PlGF ratio also correlated with longer durations of respiratory support, PN, and hospital stay.

Conclusions:

• An elevated maternal sFlt-1/PlGF ratio near delivery is a significant predictor of adverse neonatal outcomes.
• These outcomes include SGA, gastrointestinal complications, prolonged PN, and extended hospitalization, highlighting the ratio's clinical importance.