Circulating Angiogenic Factor Levels in Hypertensive Disorders of Pregnancy

Quite a few research studies have looked at whether certain proteins in the blood during pregnancy, known as biomarkers, could help predict which patients go on to develop severe preeclampsia.

For this study, researchers asked: can biomarkers measured in mid/late pregnancy predict severe preeclampsia before it happens? This study was conducted in 18 different locations across the United States. Researchers used test results of two proteins in the blood that are linked to preeclampsia (sFlt1 and PlGF) measured between 23-35 weeks of pregnancy in 299 pregnant women to first understand what the test results could be for women who go on to develop severe preeclampsia in the 2 weeks following the test.

Researchers chose a ratio number of 40 or more (of sFlt1 divided by PlGF) to predict severe preeclampsia. Then they used results from 715 pregnant women to see if a test result of 40 or more can accurately predict who would develop severe preeclampsia. The results showed the test had a 65% positive predictive value for severe preeclampsia. “Positive predictive value” means the chance a patient with a positive test will actually have severe preeclampsia. The study also found that the test had a 96% negative predictive value. “Negative predictive value” means the chance a patient with a negative test will not have severe preeclampsia. The risk for adverse outcomes for women whose result was 40 or more was nearly 6 times as high as the risk for women with a test result less than 40. 

Take home message: There is constant work in the preeclampsia field for improving our ability to predict who will develop preeclampsia. This is another study on that journey that shows sFlt1 and PlGF are important proteins in pregnant women’s blood that can tell us about preeclampsia risk. More work is needed to continue to refine using these two proteins to have a clinically available test for prediction.

Link: https://evidence.nejm.org/doi/full/10.1056/EVIDoa2200161

About Research Roundup

Each quarter, our team of researchers reviews the most current studies related to hypertensive disorders of pregnancy and selects those studies they feel will be of greatest interest to our community to summarize.

Special thanks to our volunteer research team, who under the leadership of Dr. Elizabeth Sutton, make Research Roundup possible: Alisse Hauspurg, MD Felicia LeMoine, and MD Jenny Sones, PhD, DVM.