What is the role of the soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio in neonates?

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Last updated: March 7, 2025View editorial policy

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From the Research

The sFlt-1/PlGF ratio is a valuable biomarker for predicting adverse neonatal outcomes, particularly in cases of maternal preeclampsia, and its measurement can help identify high-risk neonates who may benefit from closer monitoring and personalized care. This ratio measures soluble fms-like tyrosine kinase-1 (sFlt-1, an anti-angiogenic factor) relative to placental growth factor (PlGF, a pro-angiogenic factor) 1. In neonates born to mothers with preeclampsia, an elevated maternal sFlt-1/PlGF ratio correlates with increased risk of adverse neonatal outcomes, including prematurity, intrauterine growth restriction, and respiratory distress syndrome 2.

Key Findings

  • The sFlt-1/PlGF ratio has been shown to be a reliable tool for predicting adverse pregnancy outcomes, including preeclampsia and fetal growth restriction 3.
  • A study published in 2024 found that the sFlt-1/PlGF ratio was an efficient predictive tool for adverse neonatal outcomes in small-for-gestational-age newborns, with a ratio of 19.1 exhibiting high sensitivity but low specificity 1.
  • Another study found that the sFlt-1/PlGF ratio was a consistent predictor of livebirth and overall survival in severe early-onset fetal growth restriction pregnancies 4.

Clinical Implications

  • The sFlt-1/PlGF ratio may have prognostic value for neonatal outcomes when measured in cord blood at delivery 5.
  • While primarily used as a maternal biomarker during pregnancy, the ratio may help identify high-risk neonates who require closer monitoring and personalized care.
  • Ongoing research is exploring whether this biomarker could guide preventive interventions or personalized care for high-risk neonates 2.

Limitations and Future Directions

  • The sFlt-1/PlGF ratio is not routinely measured in neonatal clinical practice, and more studies are needed to develop an optimal and detailed formula for risk assessment of adverse outcomes in high-risk neonates 1.
  • Further research is required to validate the use of the sFlt-1/PlGF ratio as a predictive tool for adverse neonatal outcomes and to explore its potential applications in clinical practice 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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