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Recording available 2/16-5/2
Recording available 2/16-5/2
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Poster Session 4

Category: Hypertension

Poster Session 4

(1285) Predictive Value of Maternal sFlt-1/PlGF Ratio for Adverse Outcomes in Small for Gestational age Fetuses

Thursday, February 12, 2026
3:30 PM - 5:00 PM  

    Submitting Author and Presenting Author(s)

  • Uri Shemesh, MD (he/him/his)

    The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
    Tel Aviv, Tel Aviv, Israel

    • Coauthor(s)

  • Keren Zloto, MD

    sheba medical center
    Tel Hashomer, Tel Aviv, Israel

  • IM

    Itai Manor

    Sheba medical hospital
    tel aviv, HaMerkaz, Israel

  • SK

    Sharon Kronkop, N/A

    Sheba medical hospital
    tel aviv, HaMerkaz, Israel

  • MF

    May Feller

    Sheba medical hospital
    Tel Aviv, HaMerkaz, Israel

  • TD

    Tal Dadon, MD

    Doctor
    Sheba medical hospital
    Tel Aviv, HaMerkaz, Israel

  • RY

    Rakeft Yoeli Ullman, MD

    The Sheba Medical Center
    The Sheba Medical Center, HaMerkaz, Israel

  • AT

    Abraham Tsur, MBA, MD

    Director of Anterpartum High Risk Beyond, Medical Director ARC
    The Sheba Medical Center
    The Sheba Medical Center, HaMerkaz, Israel

  • SM

    Shalom Mazaki-Tovi, MD

    The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
    Ramat Gan, HaMerkaz, Israel

  • YY

    Yoav Yinon, MD

    Head of Fetal Medicine UnitChair of the Israeli Maternal Fetal Medicine Society
    Sheba Medical Center, Ramat Gan, Israel
    Ramat Gan, HaMerkaz, Israel

  • MF

    Michal Fishel Bartal, MD

    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • Noa Gonen, MD

    MFM Fellow
    Wolfson Medical Center
    Holon, HaMerkaz, Israel

Objective:
To determine whether high sFlt-1/PlGF ratio is associated with hypertensive disorders of pregnancy (HDP), adverse neonatal outcomes, and shorter time to delivery in normotensive individuals presenting with suspected small for gestational (SGA) fetuses.

Study Design:
This retrospective cohort study included all normotensive individuals with SGA fetuses who underwent sFlt-1/PlGF testing between August 2023 and May 2024 at a single tertiary center. Individuals with a diagnosis of HDP at the time of testing were excluded. Test results were not used to guide clinical management. Participants were stratified into three groups according to their sFlt-1/PlGF ratio: 0-38, 39-100, and > 100. The rate of HDP, composite adverse neonatal outcomes, and latency to delivery was determine. Diagnostic accuracy (sensitivity, specificity, positive and negative predictive values) was calculated for HDP.

Results:

Of 141 eligible individuals, 94 (66.7%) had a ratio of 0-38, 25 (17.7%) had ratios of  39-100 group, and 22 (15.6%) had ratios > 100. There was a dose affect relationship between rate of HDP and ratio categories (6.4%, 32%, 54.5%; p < 0.01, respectively), with significant differences between the lowest test and both higher groups. Similar trends were observed in composite neonatal outcome. Median time to delivery decreased with higher ratios (40.7, 29.5, 19.9 days; p = 0.019, respectively), particularly between the low and high ratio groups (p = 0.002). (Figure 1) While NPV remained high across categories (0.57–0.88), PPV improved from 0.06 to 0.55 with higher ratios, enhancing rule-in accuracy for HDP (Figure 2).

Conclusion:

In normotensive pregnancies complicated by suspected SGA, the sFlt-1/PlGF ratio is associated with elevated risk of HDP, neonatal morbidity and shorter interval to delivery in a dose-depended relationship. The findings support the use of this biomarker as a dynamic indicator in individuals with SGA with potential value in risk stratification and clinical decision-making.