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. 2022 May 9:9:894633.
doi: 10.3389/fmed.2022.894633. eCollection 2022.

sFlt-1 Is an Independent Predictor of Adverse Maternal Outcomes in Women With SARS-CoV-2 Infection and Hypertensive Disorders of Pregnancy

Jose Antonio Hernandez-Pacheco  1   2 , Johnatan Torres-Torres  1   3   4 , Raigam Jafet Martinez-Portilla  1   4 , Juan Mario Solis-Paredes  1 , Guadalupe Estrada-Gutierrez  1 , Paloma Mateu-Rogell  1   4   5 , Miguel Angel Nares-Torices  1 , Mario Enmanuel Lopez-Marenco  1 , Keren Rachel Escobedo-Segura  3 , Alejandro Posadas-Nava  3 , Jose Rafael Villafan-Bernal  4   6 , Lourdes Rojas-Zepeda  4   7 , Norma Patricia Becerra-Navarro  2 , Manuel Casillas-Barrera  2 , Mauricio Pichardo-Cuevas  2 , Cinthya Muñoz-Manrique  1   4 , Ivan Alonso Cortes-Ramirez  2 , Salvador Espino-Y-Sosa  1   4
Affiliations

sFlt-1 Is an Independent Predictor of Adverse Maternal Outcomes in Women With SARS-CoV-2 Infection and Hypertensive Disorders of Pregnancy

Jose Antonio Hernandez-Pacheco et al. Front Med (Lausanne). .

Abstract

Background: Preeclampsia (PE) and COVID-19 share a common vascular-endothelial physiopathological pathway that may aggravate or worsen women's outcomes when both coexist. This study aims to evaluate the association of sFlt-1 levels and adverse maternal outcomes among positive SARS-CoV-2 pregnant women with and without hypertensive disorders of pregnancy (HDP).

Methods: We performed a multicenter retrospective cohort study of pregnant women with confirmed SARS-CoV-2 infection that required hospital admission. The exposed cohort comprised women with a diagnosis of an HDP. The primary outcome was a composite definition of adverse maternal outcome. The association between predictors and the main and secondary outcomes was assessed using an elastic-net regression which comprised a Lasso and Ridge regression method for automatic variable selection and penalization of non-statistically significant coefficients using a 10-fold cross-validation where the best model if automatically chosen by the lowest Akaike information criterion (AIC) and Bayesian information criteria (BIC).

Results: Among 148 pregnant women with COVID-19, the best predictive model comprised sFlt-1 MoMs [odds ratio (OR): 5.13; 95% CI: 2.19-12.05], and HDP (OR: 32.76; 95% CI: 5.24-205). sFlt-1 MoMs were independently associated with an increased probability of an adverse maternal outcome despite adjusting for HDP.

Conclusions: Our study shows that sFlt-1 is an independent predictor of adverse outcomes in women with SARS-CoV-2 despite hypertension status.

Keywords: COVID-19; SARS-CoV-2; endothelial dysfunction; placental growth factor; preeclampsia; soluble fms-like tyrosine kinase-1.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Predictive probability of an adverse maternal outcome among women with hypertensive disease of pregnancy (HDP) according to sFlt-1 MoM levels.
See this image and copyright information in PMC

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