Predictive Performance of sFlt-1, PlGF and the sFlt-1/PlGF Ratio for Preeclampsia: A Systematic Review and Meta-Analysis
Luhan Zhang, Ying Feng, Wenjing Li, Qi Sun, Yuanyuan Li, Weiwei Xing, Guifeng Ding
Background: It is difficult to evaluate whether monitoring serum sFlt-1, PlGF, or sFlt-1/
PlGF in pregnant women who are suspected of having PE can significantly shorten the PE
diagnosis time.
Objectives: To estimate the accuracy of sFlt-1, PlGF and sFlt-1/PlGF in preeclampsia
prediction.
Search Strategy: Databases including PubMed, Web of Science, Medline, CNKI, SinoMed,
VIP Journal, and Wanfang Data were searched for eligible studies published until October
7, 2022.
Selection Criteria: The research subjects were pregnant women with or without PE. The
research types were case-control studies and cohort studies. This was an original study
involving the detection of at least one of the following in the blood, serum or plasma: sFlt-1,
PlGF, and sFlt-1/PlGF.
Data Collection and Analysis: Meta-Disc 1.4 was employed, using the Sen, Spe, PLR, NLR,
and DOR to plot SROC, and subgroup analysis and meta-regression were conducted.
Main Results: Meta-analysis showed that for sFlt, PlGF and sFlt-1/PlGF, the Sen was 0.811
(95% CI: 0.783-0.837), 0.735 (95% CI: 0.713–0.757), and 0.779 (95% CI: 0.763–0.795),
respectively; the Spe was 0.786 (95% CI: 0.769-0.802), 0.731 (95% CI: 0.721-0.741), and
0.885 (95% CI: 0.881-0.889), respectively. It was found to be attributable to study design,
literature quality, sample size, disease subtypes, and cut-off values by using subgroup analysis
and meta-regression.
Conclusions: The sFlt-1/PlGF ratio showed better predictive performance for preeclampsia
than sFlt-1 or PlGF alone. However, the predictive value of the latter two cannot be ignored.
