Diagnostic capacity of sFlt-1/PlGF ratio in fetal growth restriction: A systematic review and meta-analysis

We aimed to systemically investigate the diagnostic capacity of soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) ratio in fetal growth restriction (FGR).We systematically searched the PubMed, MEDLINE, Cochrane Library, and EMBASE databases for relevant studies from inception to 15 May 2022. All potentially relevant studies were assessed and then pooled.Eight studies with 339 patients and 5111 controls were included. A sFlt-1/PlGF ratio >33 was demonstrated a predictive value for FGR with a pooled sensitivity of [0.63, 95% confidence interval (CI) = 0.54-0.71], specificity of (0.84, 95% CI = 0.83-0.85), and area under the curve (AUC) of 0.8354. The pooled sensitivity, specificity, and AUC for the sFlt-1/PlGF ratio ≥85 group were 0.79 (95% CI = 0.66-0.89), 0.69 (95% CI = 0.65-0.74), and 0.8197, respectively.These findings revealed that the sFlt-1/PlGF ratio could be a potential indicator in predicting FGR and FGR + PE. More studies are needed to support the conclusion.