Diagnostic accuracy of the soluble Fms-like tyrosine kinase-1/placental growth factor ratio for preeclampsia: a meta-analysis based on 20 studies

Abstract

Purpose: To investigate the accuracy of the soluble fms-like tyrosine kinase-1(sFlt-1)/placental growth factor (PlGF) ratio to predict preeclampsia (PE).

Methods: A search in the PubMed, Embase, and Cochrane Library was conducted for human studies without language restriction. We included the studies reported sufficient data to reconstruct the diagnostic 2 × 2 table of sFlt-1/PlGF with testing of PlGF and sFlt-1 in serum or plasma. Two reviewers independently screened the articles. Disagreements were resolved by a third reviewer. Unpublished data were requested from the authors of the study by email.

Results: Twenty studies with 28 groups of women with different gestational ages were included in our study. The pooled diagnostic sensitivity and specificity of sFlt-1/PlGF were 0.78 and 0.84 with the area under the SROC curve (AUC) of 0.88. In subgroup analyses, the diagnostic value of sFlt-1/PlGF for early-onset PE is highest with a pooled diagnostic odds ratio (DOR) of 241 and AUC of 0.98.

Conclusions: The accuracy of sFlt-1/PlGF ratio for screening PE was moderate and was high for early-onset PE. High-quality studies are needed to confirm their usefulness in prediction of PE in clinical practice.