Prognostic value of serum soluble FMS-like tyrosine kinase (sFlt-1) levels in pre-eclampsia and eclampsia; a prospective cohort study

Objective: To evaluate the levels of circulating sFlt-1 in pre-eclampsia (PE) and eclampsia patients and to assess its prognostic value in detection of PE complications. Methods: The present study was a prospective cohort study conducted in tertiary hospital between January and December 2016. Included patients were divided into two groups; (Group I) severe PE group and (Group II) eclampsia group. Age-, parity-, and gestational age-matched women had approached to participate in the study as a control group (Group III). Serum sFlt-1 levels were measured at inclusion and 2days later with all basic investigations. Patients were followed up until delivery to record any complications. Correlation analysis was performed between the serum sFlt-1 levels and clinical, laboratory investigations. Receiver operating characteristic analysis was constructed for the evaluation of the area under curve (AUC) as well as the sensitivity and specificity regarding the cutoff point of sFlt-1 level that predict occurrence of complications. Results: The study included 84 women. Women with complicated severe PE showed higher sFlt-1 levels than in non-complicated cases (120.2 +/- 19.6 versus 72.2 +/- 19.6, p<0.001). Similarly, the mean serum level of sFlt-1 in complicated eclampsia was higher than in non-complicated cases (298.3 +/- 75.2 versus 128.1 +/- 36.5, p<0.001) (OR=1.119, 95% CI: 10.057-1.184, p<0.001). SFlt-1 levels were strongly correlated with systolic blood pressure (r=0.641) and diastolic blood pressure (r=0.540) (p<0.001 and p<0.001, respectively). At cutoff point 102.60ng/ml of sFlt-1 levels, the sensitivity was 90% and specificity was 80% with AUC=0.923, 95% CI: 0.871-0.975. Conclusions: Serum sFlt-1 can be used as a prognostic marker to predict the occurrence of complications of preeclampsia.