PlGF (Placental Growth Factor) Testing in Clinical Practice: Evidence From a Canadian Tertiary Maternity Referral Center
| Autor: | Rory Windrim, Melanie C. Audette, Sergio Carmona, Atif Syed, John Kingdom, John Snelgrove, Sebastian R. Hobson, Kelsey McLaughlin, Nir Melamed |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Placental growth factor medicine.medical_specialty Fetal Growth Retardation 030219 obstetrics & reproductive medicine business.industry Obstetrics Placenta Hypertension Pregnancy-Induced 030204 cardiovascular system & hematology medicine.disease Preeclampsia Clinical Practice 03 medical and health sciences 0302 clinical medicine Pregnancy Internal Medicine medicine Humans Referral center Female business Pregnancy outcomes Biomarkers Placenta Growth Factor |
| Zdroj: | Hypertension. 77:2057-2065 |
| ISSN: | 1524-4563 0194-911X |
| Popis: | There is little evidence evaluating angiogenic growth factor testing in real-world obstetric settings. This investigation evaluated maternal and perinatal pregnancy outcomes associated with maternal PlGF (placental growth factor) levels in real-world clinical care of high-risk pregnancies. From March 2017 to December 2019, 979 pregnant women with suspected risk of placental dysfunction, hypertensive disorders of pregnancy, or fetal growth restriction completed PlGF testing between 20+0 and 35+6 weeks of gestation. Maternal, fetal, and delivery characteristics were extracted through the electronic medical record system. The primary outcome of preterm birth was assessed using Royston-Parmar survival models and summarized with Kaplan-Meier methods. Of the 979 pregnant women, 289 had low PlGF levels (29.5%), and 690 had normal PlGF levels (70.5%). The survival probability of ongoing pregnancy free from preterm birth within 2- and 4-weeks following PlGF testing was significantly reduced in women with low PlGF levels, relative to women with normal PlGF levels (0.57 versus 0.99, standardized survival difference, −0.43 [95% CI, −0.76 to −0.09], and 0.37 versus 0.99, standardized survival difference, −0.62 [95% CI −0.87 to −0.38], respectively). Women with low PlGF levels were more likely to develop early-onset preeclampsia (adjusted odds ratio, 58.2 [95% CI, 32.1–105.4]) and have a stillbirth (adjusted odds ratio, 15.9 [95% CI, 7.6–33.3]). PlGF status distinguished placental from fetal causes of stillbirth. Low PlGF levels in high-risk pregnant women are strongly associated with increased rates of imminent preterm birth, as well as related adverse outcomes, including early-onset preeclampsia and stillbirth. |
| Databáze: | OpenAIRE |
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