The Sflt-1/Plgf Ratio as a Diagnostic Biomarker for Preeclampsia: A Systematic Review
Downloads
Background: Preeclampsia (PE) is a medical condition associated with placental and maternal endothelial dysfunction that can lead to complications and long-term health problems affecting both the mother and the child. Previous studies have shown that the ratio of soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) has potential in the diagnosis of PE.
Objective: This systematic review aims to determine the role of the sFlt-1/PlGF ratio as a diagnostic biomarker in preeclampsia.
Methods: This systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was performed using three electronic databases, namely PubMed, ScienceDirect, and Cochrane, up to February 2026. The inclusion criteria included studies analyzing the sFlt-1/PlGF ratio in pregnant women with singleton pregnancies. This review analyzed the cut-off values, area under the curve (AUC), sensitivity, and specificity.
Results: Four studies were included in this review, which consist of two case-control studies and two prospective cohort studies. The reported cut-off values for the sFlt-1/PlGF ratio varied across studies, including <33, <38, and ≥85. All studies demonstrated good diagnostic performance with AUC values ranging from 0.80 to 0.94. The reported sensitivity and specificity were also relatively high in detecting the occurrence of preeclampsia in pregnant women.
Conclusion: The sFlt-1/PlGF ratio is a potential biomarker that can improve the diagnostic accuracy of PE in pregnant women. The use of the sFlt-1/PlGF ratio may support patient condition identification and facilitate earlier clinical decision-making in the management of pregnancies at risk of PE.
Rahmatullah MR, Dewi R, Sari P, Romulya AI, Kedokteran F, Lampung U, et al. Epidemiologi dan Diagnosis Preeklamsia. Medula. 2024;14(2):276–80.
Verlohren S, Brennecke SP, Galindo A, Karumanchi SA, Mirkovic LB, Schlembach D, et al. Clinical interpretation and implementation of the sFlt-1 / PlGF ratio in the prediction, diagnosis and management of preeclampsia. Pregnancy Hypertens An Int J Women’s Cardiovasc Heal [Internet]. 2022;27(August 2021):42–50. Available from: https://doi.org/10.1016/j.preghy.2021.12.003
Zeisler H, Llurba E, Chantraine F, Vatish M, Staff AC, Sennström M, et al. Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia. N Engl J Med. 2016;374(1):13–22.
Ohkuchi A, Saito S, Yamamoto T, Minakami H, Masuyama H. Short-term prediction of preeclampsia using the sFlt-1 / PlGF ratio : a subanalysis of pregnant Japanese women from the PROGNOSIS Asia study. Hypertens Res [Internet]. 2021;44:813–21. Available from: http://dx.doi.org/10.1038/s41440-021-00629-x
Ding G, Liping L, Moli D, Wuliyeti A, Shaohe Z, Chen P, et al. A study of the association between the sFlt-1 / PIGF ratio and preeclampsia in Xinjiang Uygur Autonomous Region of China. Artif Cells, Nanomedicine, Biotechnol [Internet]. 2019;46(S3):S281–6. Available from: https://doi.org/10.1080/21691401.2018.1491480
Stepan H, Hund M, Gencay M, Denk B, Dinkel C, Kaminski WE, et al. A comparison of the diagnostic utility of the sFlt-1 / PlGF ratio versus PlGF alone for the detection of preeclampsia / HELLP syndrome. Hypertens Pregnancy [Internet]. 2016;35(3):295–305. Available from: http://dx.doi.org/10.3109/10641955.2016.1141214
Zhu M, Liu J, Cao J, Ni Y, Chang M, Chen R, et al. Validation of a new kit for preeclampsia screening : A comprehensive analysis. Heliyon [Internet]. 2024;10(6):e28080. Available from: https://doi.org/10.1016/j.heliyon.2024.e28080
Nikuei P, Rajaei M, Roozbeh N, Mohseni F, Poordarvishi F, Azad M. Diagnostic accuracy of sFlt1 / PlGF ratio as a marker for preeclampsia. BMC Pregnancy Childbirth. 2020;20(80):4–9.
Serudji J, Basyir V, Tara Fadhillah. Differentiating Maternal Angiogenesis Factors between Early and Late Onset Preeclampsia: Higher sflt-1 in Early Onset Preeclampsia, Lower PlGF and Higher sflt-1/PlGF Ratio in Late Onset Preeclampsia. Mol Cell Biomed Sci. 2024;8(3):154–8.
Copyright (c) 2026 I Kadek Ade Juniantara, Nyoman Gede Dikawijaya Satriawan, Anak Agung Istri Agung Aprilla Berlianti, I Putu Willy Ganang Arta Putra
This work is licensed under a Creative Commons Attribution 4.0 International License.
All Content should be original and unpublished.
