Prognostic indicators of severe disease in late preterm pre-eclampsia to guide decision making on timing of delivery: The PEACOCK study

To assess the diagnostic performance of angiogenic biomarkers in determining need for delivery seven days women with late preterm preeclampsia. In a prospective observational cohort study 36 maternity units across England and Wales, we studied accuracy placental growth factor (PlGF) sFlt-1 risk complications requiring (34+0 to 36+6 weeks' gestation) Angiogenic were measured using Quidel Roche (sFlt-1:PlGF ratio) assays. Additional clinical data was obtained use within established ‘Prediction early-onset pre-eclampsia’ (PREP)-S prognostic model. Biomarkers assessed standard methods (sensitivity, specificity, Receiver Operator Curve areas). Estimated probability early from PREP-S compared actual event rates. Clinically indicated pre-eclampsia days. PlGF (Quidel) testing had high sensitivity (97.9%) days, but negative predictive value only 71.4%, low specificity (8.4%), similar results sFlt-1/PlGF assay. The area under curve 0.60 (SE 0.03), 0.65 (0.03), 0.64 (0.03) combination PlGF, sFlt-1:PlGF, respectively. do not add assessment help determine pre-eclampsia. Existing models developed predict cannot be used clinically