Abnormal placental growth factor tied to adverse neonatal and maternal outcomes

  • Parchem JG & al.
  • Obstet Gynecol
  • 1 Mar 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Pregnant women with suspected pre-eclampsia and abnormal plasma placental growth factor (PlGF) were at an increased risk for adverse neonatal and maternal outcomes.

Why this matters

  • Findings suggest that PlGF may be useful for risk stratification of women with suspected preeclampsia

Study design

  • A secondary analysis of PETRA trial included 1112 women with a singleton pregnancy between 20 and 41 weeks of gestation and suspected pre-eclampsia.
  • All women were stratified by PIGF levels (low PIGF: ≤100 pg/mL [n=742] vs >100 pg/mL [n=370]; very low PIGF:
  • Primary outcomes: composite adverse neonatal and maternal outcomes.
  • Funding: None.

Key results

  • The overall rates of the composite adverse neonatal and maternal outcomes were 6.4% and 4.8%, respectively.
  • Women with low vs normal PIGF were at an increased risk for composite neonatal (adjusted relative risk [aRR], 17.2; 95% CI, 5.2-56.3) and maternal (aRR, 3.6; 95% CI, 1.7-8.0; P<.001 for both outcomes.>
  • Very low vs normal PlGF was linked to an increased risk for neonatal (aRR, 6.7; 95% CI, 3.7-12.2) and maternal (aRR, 3.1; 95% CI, 1.8-5.3) outcomes.
  • The sensitivity and specificity of low PIGF for composite neonatal outcome were 95.8% and 35.3%, respectively, whereas sensitivity and specificity for the composite maternal outcome were 86.8% and 34.3%, respectively.
  • The positive predictive values of low PIGF was poor for neonatal (9.2%) and maternal (6.2%) outcomes.
  • Low PIGF had a high negative predictive value for both neonatal (99.2%) and maternal (98.1%) outcomes.

Limitations

  • Potential risk of residual confounding.