Plasma placenta growth factor levels in midtrimester pregnancies

Tjoa, May Lee; Vugt, J. M. van; Mulders, Monique A.M.; Schutgens, R. B. H.; Oudejans, Cees B.M.; Wijk, Inge J. van

doi:10.1016/s0029-7844(01)01497-1

Cited by 74 publications

(29 citation statements)

References 22 publications

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“…Some of the more significant associations found between PlGF and adverse pregnancy outcomes have measured PlGF in mid-gestation rather than at 11–14 weeks. 24,25,47,48 Although one longitudinal study 22 demonstrated a significant association between PlGF and SGA as early as the first trimester, a second could not detect such differences until the second trimester. 47 In addition, because our observed prevalence of SGA10 (9.6%) was less than the expected 14%, we were underpowered to detect the 70% sensitivity for predicting SGA10.…”

Section: Discussionmentioning

confidence: 99%

First-trimester placental ultrasound and maternal serum markers as predictors of small-for-gestational-age infants

Schwartz

Sammel

Leite

et al. 2014

American Journal of Obstetrics and Gynecology

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Objective To combine early, direct assessment of the placenta with indirect markers of placental development to identify pregnancies at greatest risk of delivering small-for-gestational age infants (SGA10). Methods We prospectively collected 3D-ultrasound volume sets, uterine artery pulsatility index (UtAPI) and maternal serum of singleton pregnancies at 11–14 weeks. Placental volume (PV), quotient (PQ=PV/gestational age), mean placental and chorionic diameters (MPD and MCD, respectively), and the placental morphology index (PMI=MPD/PQ and adjusts the lateral placental dimensions for quotient) were measured offline. Maternal serum was assayed for placental growth factor (PlGF) and placental protein-13 (PP13). These variables were evaluated as predictors of SGA10. Results Of the 578 pregnancies included in the study, 56 (9.7%) delivered SGA10. SGA10 pregnancies had a significantly smaller PV, PQ, MPD and MCD and higher PMI compared to normal pregnancies (P<0.001 for each). Each placental measure remained significantly associated with SGA10 after adjusting for confounders and significantly improved the performance of the model using clinical variables alone (P<0.04 for each) with adjusted AUCs ranging from 0.71 to 0.74. UtAPI did not remain significantly associated with SGA10 after adjusting for confounders (P=0.06). PlGF was significantly lower in SGA10 pregnancies (P=0.02) and remained significant in adjusted models, but failed to significantly improve the predictive performance of the models as measured by AUC (P>0.3). PP13 was not associated with SGA10 (P=0.99). Conclusions Direct assessment of placental size and shape with 3-dimensional ultrasound can serve as the foundation upon which to build a multivariable model for the early prediction of SGA.

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Section: Discussionmentioning

confidence: 99%

First-trimester placental ultrasound and maternal serum markers as predictors of small-for-gestational-age infants

Schwartz

Sammel

Leite

et al. 2014

American Journal of Obstetrics and Gynecology

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“…[1–47] Indeed, patients with preeclampsia have higher plasma concentrations of sVEGFR-1[7–10,12,13,16,21,22,24,27,29,29,31,33,34,39,41,42,46,48] and sEng[25,30,34–36,42,45,46,48] and lower plasma concentration of VEGF[8,49] and PlGF[3,5,6,8,11,12,14,27,29,33,38,39,41,42,46,49–51] than patients with normal pregnancies at the time of the clinical diagnosis of preeclampsia. These differences have been observed even before the clinical presentation of the disease.…”

Section: Introductionmentioning

confidence: 99%

A prospective cohort study of the value of maternal plasma concentrations of angiogenic and anti-angiogenic factors in early pregnancy and midtrimester in the identification of patients destined to develop preeclampsia

Kusanovic

Romero²,

Chaiworapongsa

et al. 2009

The Journal of Maternal-Fetal & Neonatal Medicine

250

141

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OBJECTIVE Changes in the maternal plasma concentrations of angiogenic (such as PlGF and VEGF) and anti-angiogenic factors (such as sEng and sVEGFR-1) precede the clinical presentation of preeclampsia. This study was conducted to examine the role of maternal plasma PlGF, sEng and sVEGFR-1 concentrations in early pregnancy and midtrimester in the identification of patients destined to develop preeclampsia. METHODS This longitudinal cohort study included 1,622 consecutive singleton pregnant women. Plasma samples were obtained in early pregnancy (6–15 weeks) and midtrimester (20–25 weeks). Maternal plasma PlGF, sEng and sVEGFR-1 concentrations were determined using sensitive and specific immunoassays. The primary outcome was the development of preeclampsia. Secondary outcomes included term, preterm and early-onset preeclampsia. Receiving operating characteristic (ROC) curves, sensitivity, specificity, positive and negative likelihood ratios, and multivariable logistic regression were used for statistical analyses. A p-value of <0.05 was considered significant. RESULTS 1) The prevalence of preeclampsia, term, preterm (<37 weeks) and early-onset preeclampsia (<34 weeks) was 3.8% (62/1,622), 2.5% (40/1,622), 1.4% (22/1,622) and 0.6% (9/1,622), respectively; 2) Higher likelihood ratios were provided by ratios of midtrimester plasma concentrations of PlGF, sEng, and sVEGFR-1 than single analytes; 3) Individual angiogenic and anti-angiogenic factors did not perform well in the identification of preeclampsia as a whole; in particular, they perform poorly in the prediction of term preeclampsia; 4) In contrast, a combination of these analytes such as the PlGF/sEng ratio, its delta and slope had the best predictive performance with a sensitivity of 100%, a specificity of 98%–99%, and likelihood ratios for a positive test of 57.6, 55.6 and 89.6, respectively, for predicting early-onset preeclampsia. CONCLUSIONS 1) The PlGF/sEng ratio and its delta and slope had an excellent predictive performance for the prediction of early-onset preeclampsia, with very high likelihood ratios for a positive test result and very low likelihood ratios for a negative test result; and 2) Although the positive likelihood ratios are high and the positive predictive values low, the number of patients needed to be closely followed is 4:1 for the PlGF/sEng ratio and 3:1 for the slope of PlF/sEng.

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“…[17,18,31–37] Recently, sVEGFR-2 has also been implicated in the pathophysiology of preeclampsia. [38–40] Since these differences can be observed before the clinical diagnosis of the disease,[6–11,15,26,35,41–47] it has been proposed that the measurement of plasma/serum concentrations of angiogenic and anti-angiogenic factors in the first and/or second trimester of pregnancy,[7,11,14,16–18,48–53] alone or in combination with the results of Doppler velocimetry of the uterine arteries,[20,29,37,54–60] may serve as an assessment tool to identify women at risk to develop preeclampsia.…”

Section: Introductionmentioning

confidence: 99%

Serum and plasma determination of angiogenic and anti-angiogenic factors yield different results: The need for standardization in clinical practice

Oggè¹,

Romero²,

Kusanovic³

et al. 2010

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective The importance of an anti-angiogenic state as a mechanism of disease in preeclampsia is now recognized. Assays for the determination of concentrations of soluble vascular endothelial growth factor receptor (sVEGFR)-1, sVEGFR-2, placental growth factor (PlGF) and soluble endoglin (sEng) have been developed for research and clinical laboratories. A key question is whether these factors should be measured in plasma or serum. The purpose of this study was to determine if there are differences in the concentrations of these analytes between plasma and serum in normal pregnancy and in preeclampsia. Methods Samples of maternal blood were obtained by venipuncture and collected in EDTA (lavender top) and serum collection tubes (red top). A standard laboratory procedure was implemented for the centrifugation, aliquoting and storage of samples. Plasma and serum from 70 women with normal pregnancies and 34 patients with preeclampsia, were assayed for sVEGFR-1, sVEGFR-2, PlGF and sEng by ELISA. Non-parametric paired tests were used for analyses. Results A significant difference between plasma and serum concentration was observed for sVEGFR-1 and sVEGFR-2 in normal pregnancy, and for sVEGFR-1, sVEGFR-2, PlGF and sEng in women with preeclampsia. Conclusion The concentrations of sVEGFR-1, sVEGFR-2, PlGF and sEng when measured in maternal plasma and in serum are different. Therefore, the matrix used for the assay (serum versus plasma) needs to be considered when selecting thresholds for predictive studies and interpreting the growing body of literature on this subject.

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Plasma placenta growth factor levels in midtrimester pregnancies

Abstract: Our results show that plasma placenta growth factor levels are decreased before preeclampsia is clinically evident. The data suggest that placenta growth factor may be useful to determine the relative risk of developing preeclampsia and intrauterine growth restriction.

Cited by 74 publications

References 22 publications

First-trimester placental ultrasound and maternal serum markers as predictors of small-for-gestational-age infants

First-trimester placental ultrasound and maternal serum markers as predictors of small-for-gestational-age infants

A prospective cohort study of the value of maternal plasma concentrations of angiogenic and anti-angiogenic factors in early pregnancy and midtrimester in the identification of patients destined to develop preeclampsia

Serum and plasma determination of angiogenic and anti-angiogenic factors yield different results: The need for standardization in clinical practice

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