Plasma concentrations of angiogenic/anti-angiogenic factors have prognostic value in women presenting with suspected preeclampsia to the obstetrical triage area: a prospective study. (January 2014)

• Record Type: Journal Article
• Authors: Chaiworapongsa, Tinnakorn; Romero, Roberto; Korzeniewski, Steven J.; Cortez, Josef M.; Pappas, Athina; Tarca, Adi L.; Chaemsaithong, Piya; Dong, Zhong; Yeo, Lami; Hassan, Sonia S.
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 27:Number 2(2014:Feb.)
• Page Start: 132
• Page End: 144
• Publication Date: 2014-01
• Subjects: Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2013.806905
• Languages: English
• ISSNs: 1476-7058

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objective</italic>: To prospectively determine the prognostic value of maternal plasma concentrations of placental growth factor (PlGF), soluble endoglin (sEng) and soluble vascular endothelial growth factor receptors-1 and -2 (sVEGFR-1 and -2) in identifying patients with suspected preeclampsia (PE), who require preterm delivery (PTD) or develop adverse outcomes.</p> <p> <italic>Study design</italic>: This prospective cohort study included 85 consecutive patients who presented to the obstetrical triage area at 20–36 weeks with a diagnosis of "rule out PE." Patients were classified as: 1) those who remained stable until term (<italic>n = </italic>37); and 2) those who developed severe PE and required PTD (<italic>n = </italic>48). Plasma concentrations of PlGF, sEng and sVEGFR-1 and -2 were determined by ELISA.</p> <p> <italic>Results</italic>: Patients with PlGF/sVEGFR-1 ≤0.05 multiples of the median (MoM) or PlGF/sEng ≤0.07 MoM were more likely to deliver preterm due to PE [adjusted odd ratio (aOR) 7.4 and 8.8], and to develop maternal (aOR 3.7 and 2.4) or neonatal complications (aOR 10.0 and 10.1). Among patients who presented <34 weeks of gestation, PlGF/sVEGFR-1 ≤ 0.035 MoM or PlGF/sEng ≤0.05 MoM had a sensitivity of 89% (16/18), specificity of 96% (24/25) and likelihood ratio for a positive test of 22 to identify patients who delivered within 2 weeks. The addition of the PlGF/sVEGFR-1 ratio to standard clinical tests improved the sensitivity at a fixed false-positive rate of 3% (<italic>p</italic> = 0.004) for the identification of patients who were delivered due to PE within 2 weeks. Among patients who had a plasma concentration of PlGF/sVEGFR-1 ratio ≤0.035 MoM, 0.036-0.34 MoM and ≥0.35 MoM, the rates of PTD <34 weeks were 94%, 27% and 7%, respectively.</p> <p> <italic>Conclusions</italic>: The determination of angiogenic/anti-angiogenic factors has prognostic value in patients presenting to the obstetrical triage area with suspected PE for the identification of those requiring preterm delivery and at risk for adverse maternal/neonatal outcomes.</p> </abstract>