Prediction of birth weight small for gestational age with and without preeclampsia by angiogenic markers: an Odense Child Cohort study

Thorsen, Lena; Andersen, Louise Bjørkholt; Birukov, Anna; Lykkedegn, Sine; Dechend, Ralf; Jørgensen, Jan Stener; Christesen, Henrik Thybo

doi:10.1080/14767058.2018.1519536

Cited by 5 publications

(6 citation statements)

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“…Biomarker measurements of placental functioning-related substances have had significant development in the last three decades. Many of these compounds are also involved with antenatal detection of chromosomal anomalies, or preeclampsia, such as PAPP-A, AFP, PlGF, or sFLt-1 [41] (Table 2). Studies from the mid 1980s have evaluated the human placental lactogen (hPL), when it demonstrated a diagnostic odds ratio (DOR) of 4.78 (95% CI 3.21–7.13), whereas more recent data focus on angiogenic biomarkers [44].…”

Section: When and How We Should Screen For Fetal Growth Restriction?mentioning

confidence: 99%

“…PlGF has consistently lower levels in SGA pregnancies, in 2 nd and 3 rd trimesters [82–84], especially for BW < 5 th or <10 th centiles. For higher sFlt-1/PlGF ratios, there is better AUC for preeclampsia-associated SGA [40, 41]. These findings point in the direction of angiogenesis-mediated pathophysiology of SGA, especially when there are Doppler abnormal parameters [37].…”

Section: When and How We Should Screen For Fetal Growth Restriction?mentioning

confidence: 99%

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Fetal Growth Restriction Prediction: How to Move beyond

Leite

Cecatti

2019

The Scientific World Journal

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The actual burden and future burden of the small-for-gestational-age (SGA) babies turn their screening in pregnancy a question of major concern for clinicians and policymakers. Half of stillbirths are due to growth restriction in utero, and possibly, a quarter of livebirths of low- and middle-income countries are SGA. Growing body of evidence shows their higher risk of adverse outcomes at any period of life, including increased rates of neurologic delay, noncommunicable chronic diseases (central obesity and metabolic syndrome), and mortality. Although there is no consensus regarding its definition, birthweight centile threshold, or follow-up, we believe birthweight <10th centile is the most suitable cutoff for clinical and epidemiological purposes. Maternal clinical factors have modest predictive accuracy; being born SGA appears to be of transgenerational heredity. Addition of ultrasound parameters improves prediction models, especially using estimated fetal weight and abdominal circumference in the 3rd trimester of pregnancy. Placental growth factor levels are decreased in SGA pregnancies, and it is the most promising biomarker in differentiating angiogenesis-related SGA from other causes. Unfortunately, however, only few societies recommend universal screening. SGA evaluation is the first step of a multidimensional approach, which includes adequate management and long-term follow-up of these newborns. Apart from only meliorating perinatal outcomes, we hypothesize SGA screening is a key for socioeconomic progress.

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Section: When and How We Should Screen For Fetal Growth Restriction?mentioning

confidence: 99%

Section: When and How We Should Screen For Fetal Growth Restriction?mentioning

confidence: 99%

Fetal Growth Restriction Prediction: How to Move beyond

Leite

Cecatti

2019

The Scientific World Journal

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“…B, Blood samples were categorized into 3 groups based on gestational age at collection: on or before gw 16, on or before gw 24, and after gw 24. The median gestational age at the time of collection was gw 14 (IQR, 12,15) for the first group, gw 22 (IQR, 20,24) for the second group, and gw 29 (IQR, 28,30)…”

Section: Nonstandard Abbreviations and Acronymsmentioning

confidence: 99%

High-Sensitivity Cardiac Troponin I Enhances Preeclampsia Prediction Beyond Maternal Factors and the sFlt-1/PlGF Ratio

Bacmeister,

Goßling,

Buellesbach

et al. 2024

Circulation

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BACKGROUND: Preeclampsia shares numerous risk factors with cardiovascular diseases. Here, we aimed to assess the potential utility of high-sensitivity cardiac troponin I (hs-cTnI) values during pregnancy in predicting preeclampsia occurrence. METHODS: This study measured hs-cTnI levels in 3721 blood samples of 2245 pregnant women from 4 international, prospective cohorts. Three analytical approaches were used: (1) a cross-sectional analysis of all women using a single blood sample, (2) a longitudinal analysis of hs-cTnI trajectories in women with multiple samples, and (3) analyses of prediction models incorporating hs-cTnI, maternal factors, and the sFlt-1 (soluble fms-like tyrosine kinase 1)/PlGF (placental growth factor) ratio. RESULTS: Women with hs-cTnI levels in the upper quarter had higher odds ratios for preeclampsia occurrence compared with women with levels in the lower quarter. Associations were driven by preterm preeclampsia (odds ratio, 5.78 [95% CI, 2.73–12.26]) and remained significant when using hs-cTnI as a continuous variable adjusted for confounders. Between-trimester hs-cTnI trajectories were independent of subsequent preeclampsia occurrence. A prediction model incorporating a practical hs-cTnI level of detection cutoff (≥1.9 pg/mL) alongside maternal factors provided comparable performance with the sFlt-1/PlGF ratio. A comprehensive model including sFlt-1/PlGF, maternal factors, and hs-cTnI provided added value (cross-validated area under the receiver operator characteristic, 0.78 [95% CI, 0.73–0.82]) above the sFlt-1/PlGF ratio alone (cross-validated area under the receiver operator characteristic, 0.70 [95% CI, 0.65–0.76]; P =0.027). As assessed by likelihood ratio tests, the addition of hs-cTnI to each prediction model significantly improved the respective prediction model not incorporating hs-cTnI, particularly for preterm preeclampsia. Net reclassification improvement analyses indicated that incorporating hs-cTnI improved risk prediction predominantly by correctly reclassifying women with subsequent preeclampsia occurrence. CONCLUSIONS: These exploratory findings uncover a potential role for hs-cTnI as a complementary biomarker in the prediction of preeclampsia. After validation in prospective studies, hs-cTnI, alongside maternal factors, may either be considered as a substitute for angiogenic biomarkers in health care systems where they are sparce or unavailable, or as an enhancement to established prediction models using angiogenic markers.

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“…The sFlt-1/PlGF ratio is inversely correlated with BW [ 78 , 79 ] and a high ratio is present in pregnancies complicated by FGR [ 80 ]. Furthermore, although the sFlt-1/PlGF ratio is elevated regardless of the gestation at which FGR is diagnosed, early-onset FGR is associated with higher ratios compared with late-onset FGR, suggesting a possible lesser degree of placental dysfunction in the latter group [ 78 , 81 ].…”

Section: Angiogenic Factorsmentioning

confidence: 99%

Circulating biomarkers associated with placental dysfunction and their utility for predicting fetal growth restriction

Hong

Kumar

2023

Clinical Science

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Fetal growth restriction (FGR) leading to low birth weight (LBW) is a major cause of neonatal morbidity and mortality worldwide. Normal placental development involves a series of highly regulated processes involving a multitude of hormones, transcription factors, and cell lineages. Failure to achieve this leads to placental dysfunction and related placental diseases such as pre-clampsia and FGR. Early recognition of at-risk pregnancies is important because careful maternal and fetal surveillance can potentially prevent adverse maternal and perinatal outcomes by judicious pregnancy surveillance and careful timing of birth. Given the association between a variety of circulating maternal biomarkers, adverse pregnancy, and perinatal outcomes, screening tests based on these biomarkers, incorporating maternal characteristics, fetal biophysical or circulatory variables have been developed. However, their clinical utility has yet to be proven. Of the current biomarkers, placental growth factor and soluble fms-like tyrosine kinase 1 appear to have the most promise for placental dysfunction and predictive utility for FGR.

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Prediction of birth weight small for gestational age with and without preeclampsia by angiogenic markers: an Odense Child Cohort study

Abstract: The sFlt-1/PlGF ratio is a potential predictor of SGA in population-based screening, particularly when preeclampsia is also present.

Cited by 5 publications

References 44 publications

Fetal Growth Restriction Prediction: How to Move beyond

Fetal Growth Restriction Prediction: How to Move beyond

High-Sensitivity Cardiac Troponin I Enhances Preeclampsia Prediction Beyond Maternal Factors and the sFlt-1/PlGF Ratio

Circulating biomarkers associated with placental dysfunction and their utility for predicting fetal growth restriction

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