For a study, researchers sought to conduct a comprehensive assessment of the efficacy of soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and the sFlt-1/PlGF ratio in predicting bad outcomes in preeclamptic women. From 1989 to March 2019, researchers conducted a comprehensive search of the MEDLINE, EMBASE, CINAHL, Cochrane, Scopus, ClinicalTrials.gov, and Emcare databases for studies that linked sFlt-1, PlGF, and the sFlt-1/PlGF ratio to the prevalence of poor outcomes in women with preeclampsia. Covidence was used by two independent reviewers to screen 3,194 papers. Studies were selected if they investigated the predictive ability of sFLT-1, PlGF, or the sFLT-1/PlGF ratio in women with suspected or confirmed preeclampsia.
They obtained contingency tables containing true-positive, false-positive, true-negative, and false-negative outcomes. A bivariate mixed-effects meta-analysis was used to assess sensitivity, specificity, diagnostic odds ratios, and the area under the summary receiver operating characteristic curve (area sROC). The search yielded 3,194 publications, 33 of which were included (n=9,426 patients). In terms of the biomarkers and outcomes investigated, there was substantial diversity among the included studies. As a result, only a few studies (n=4–8) were included in the meta-analysis component, resulting in high heterogeneity between studies (I2=33–99). Nonetheless, PlGF and the sFlt-1/PlGF ratio had area sROC values ranging from 0.68 to 0.87 for the prediction of composite unfavorable maternal and perinatal outcomes, preterm delivery, and fetal growth limitation. The sFlt-1/PlGF ratio and placental growth factor offered the predictive potential for bad outcomes in preeclampsia, but research heterogeneity restricted their therapeutic value.
