sFlt-1/PlGF Ratio in Subsequent Pregnancies After Preeclampsia and Partner Change

The sFlt-1/PlGF ratio predicts preeclampsia-related adverse outcomes within a pregnancy, but does not predict the outcome of a subsequent pregnancy. We studied individual changes in angiogenic biomarkers in 10 women with measurements available from two pregnancies. All had preeclampsia in at least the index pregnancy; six had recurrent preeclampsia. In the subsequent pregnancy, biomarker sampling and delivery generally occurred later, and the clinical phenotype was less severe. Median gestational age at biomarker measurement increased from 26 + 1 to 30 + 6 weeks and gestational age at delivery from 32 + 5 to 37 + 1 weeks. Median sFlt-1 decreased five- fold, PlGF increased, and the sFlt-1/PlGF ratio decreased approximately 50-fold. Of seven women with an index ratio > 85, six had a ratio ≤ 85 in the subsequent pregnancy. One woman, who conceived with a new partner, showed the opposite pattern: the ratio increased from 3 to 472, and delivery occurred at 23 + 0 weeks. Thus, the sFlt-1/PlGF ratio tracked the phenotype of the ongoing pregnancy, but did not predict the course of the next pregnancy. In this small series, the observation after partner change suggests that partner-related factors may modify recurrence severity, but requires confirmation in larger cohorts.