ArticleBMC pregnancy and childbirth2026
Effect of prophylactic subcutaneous unfractionated heparin on the maternal sFlt-1/PlGF ratio: a retrospective cohort study.
Article in BMC pregnancy and childbirth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe ratio of soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) is widely used to assess the risk of preeclampsia. However, heparin can transiently increase the level of circulating sFlt-1, making it unclear whether prophylactic subcutaneous unfractionated heparin (UFH)-commonly used for thromboprophylaxis in pregnancy-affects the reliability of this biomarker.
methodsWe conducted a retrospective cohort study to compare mid-trimester (18w0d-23w6d) sFlt-1 levels and sFlt-1/PlGF ratios in 45 pregnant women receiving prophylactic subcutaneous UFH for antiphospholipid syndrome or a history of thrombosis and 563 controls. We also examined the association between biomarker levels and time elapsed since the last UFH injection.
resultsMid-trimester sFlt-1 levels (1900 vs. 1782 pg/mL, p = 0.15) and sFlt-1/PlGF ratios (7.2 vs. 6.7, p = 0.87) were equivalent between the UFH and control groups. Multivariate regression analysis adjusting for maternal age, body mass index, gestational age at sampling, and low-dose aspirin intake confirmed no significant association between prophylactic UFH and sFlt-1 levels or sFlt-1/PlGF ratios. Within the UFH group, no correlation was found between the time since administration (range 63-477 min) and sFlt-1 levels (r=-0.049, p = 0.75) or sFlt-1/PlGF ratios (r = 0.019, p = 0.90).
conclusionProphylactic subcutaneous UFH was not associated with significant differences in sFlt-1/PlGF ratios, and the serum levels were not correlated with the timing of administration within the examined window. These findings suggest that the sFlt-1/PlGF ratio may remain a reliable tool for preeclampsia risk assessment in women receiving UFH prophylaxis under routine clinical sampling conditions.
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