Abnormal Soluble fms-like Tyrosine Kinase to Placental Growth Factor Ratio during Pregnancy and Subjective Memory Impairment 3-6 Years Postpartum.
Preeclampsia is a pregnancy-related disorder characterized by systemic endothelial dysfunction and angiogenic imbalance, most notably elevated levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and decreased placental growth factor (PlGF). While preeclampsia has been associated with long-term cardiovascular and cognitive risks, the specific role of angiogenic imbalance in predicting postpartum memory impairment remains unclear. Identifying biomarkers that can anticipate future neurocognitive outcomes may offer opportunities for early intervention and monitoring.
To evaluate whether preeclampsia and angiogenic imbalance during pregnancy, defined by an sFlt-1/PlGF ratio ≥38, are associated with subjective memory impairment 3 to 6 years postpartum.
Cross-sectional study at a tertiary hospital in Barcelona, Spain. Individuals were prospectively recruited during pregnancy and re-evaluated 3 to 6 years postpartum. Preeclampsia was defined per ACOG criteria. Angiogenic imbalance during pregnancy was defined as sFlt-1/PlGF ≥38 (determined between 28 and 40 weeks of gestation). Subjective memory performance was assessed using the validated Memory Failures of Everyday Life (MFE-30) questionnaire. Memory impairment was defined as a total MFE-30 score ≥36. Logistic and linear regression models were used to examine associations, adjusting for relevant confounders.
A total of 266 individuals were re-evaluated between August 2023 and February 2025. 81 of them (30.45%) had a documented history of PE. Participants with an elevated sFlt-1/PlGF ratio during pregnancy showed a higher prevalence of memory impairment (30.0% vs. 16.2%, p = 0.03). In multivariable analysis, angiogenic imbalance remained significantly associated with increased odds of memory impairment (odds ratio = 2.18, 95% CI [1.02-4.65], p = 0.04). In contrast, preeclampsia diagnosis alone was not significantly associated with memory outcomes (odds ratio = 1.35, 95% CI [0.70 to 2.60], p = 0.37).
An elevated sFlt-1/PlGF ratio during pregnancy is associated with increased risk of subjective memory impairment 3 to 6 years postpartum. These findings highlight the potential utility of angiogenic biomarkers as early indicators of long-term cognitive vulnerability, supporting the need for longitudinal follow-up and targeted preventive strategies in women exposed to angiogenic imbalance during pregnancy.
To evaluate whether preeclampsia and angiogenic imbalance during pregnancy, defined by an sFlt-1/PlGF ratio ≥38, are associated with subjective memory impairment 3 to 6 years postpartum.
Cross-sectional study at a tertiary hospital in Barcelona, Spain. Individuals were prospectively recruited during pregnancy and re-evaluated 3 to 6 years postpartum. Preeclampsia was defined per ACOG criteria. Angiogenic imbalance during pregnancy was defined as sFlt-1/PlGF ≥38 (determined between 28 and 40 weeks of gestation). Subjective memory performance was assessed using the validated Memory Failures of Everyday Life (MFE-30) questionnaire. Memory impairment was defined as a total MFE-30 score ≥36. Logistic and linear regression models were used to examine associations, adjusting for relevant confounders.
A total of 266 individuals were re-evaluated between August 2023 and February 2025. 81 of them (30.45%) had a documented history of PE. Participants with an elevated sFlt-1/PlGF ratio during pregnancy showed a higher prevalence of memory impairment (30.0% vs. 16.2%, p = 0.03). In multivariable analysis, angiogenic imbalance remained significantly associated with increased odds of memory impairment (odds ratio = 2.18, 95% CI [1.02-4.65], p = 0.04). In contrast, preeclampsia diagnosis alone was not significantly associated with memory outcomes (odds ratio = 1.35, 95% CI [0.70 to 2.60], p = 0.37).
An elevated sFlt-1/PlGF ratio during pregnancy is associated with increased risk of subjective memory impairment 3 to 6 years postpartum. These findings highlight the potential utility of angiogenic biomarkers as early indicators of long-term cognitive vulnerability, supporting the need for longitudinal follow-up and targeted preventive strategies in women exposed to angiogenic imbalance during pregnancy.
Authors
Platero Platero, Garcia-Manau Garcia-Manau, Costa Costa, Garcia Garcia, Garrido-Giménez Garrido-Giménez, Pellicer Pellicer, Ullmo Ullmo, Jordi Jordi, Nan Nan, Mora Mora, Garcia-Osuna Garcia-Osuna, Sánchez-Garcia Sánchez-Garcia, Choliz Choliz, Cruz-Lemini Cruz-Lemini, Llurba Llurba
View on Pubmed