(875) Angiogenic Factors for Prediction of Adverse Outcomes in Pregnancies Complicated by Isolated Fetal Growth Restriction

Objective: To evaluate whether abnormal sFlt-1/PlGF ratio predicts latency to delivery and development of hypertensive disorders of pregnancy (HDP) among individuals presenting with fetal growth restriction (FGR)

Study Design: A retrospective study including individuals at ≥ 23 weeks presenting to a tertiary care center with suspected FGR (< 10th percentile) (08/2023 to 04/2024). During this period, sFlt-1/PlGF levels were obtained for all individuals with FGR but were not used to guide
clinical management. Patients with HDP on presentation were excluded. Median interval to delivery, rate of HDP, and other adverse

outcomes were compared between those with and without abnormal sFLT-1/PLGF ratio (≥ 38).
Odds ratio and 95% confidence interval (95%CI) were calculated.

Results:

Of 104 patients with suspected FGR, 36 (34.6%) had an abnormal ratio of sFlt-1/PlGF (≥38). Those with abnormal sFlt-1/PlGF levels were more likely to be nulliparous compared to those with normal testing (Table 1). The rate of HDP was higher among those with abnormal sFlt- 1/PlGF ratio (30.6% Vs 2.94%, p< 0.01, OR14.5 (3-70.2)) with a shorter median latency from test to delivery (20 vs 36 days, p< 0.01) compared to normal testing. Furthermore, those with abnormal sFlt- 1/PlGF ratio delivered earlier (35.4 vs. 37.1, p< 0.01) with a lower birthweight (1876 vs 2182 gram, p< 0.01) compared to those with normal testing. 

 

Conclusion: Abnormal sFlt-1/PlGF ratio in normotensive individuals with suspected FGR may predict short interval to delivery, development of HDP, and adverse perinatal outcomes.