Prediction of stillbirth from biochemical and biophysical markers at 11–13 weeks

Mastrodima, S.; Akolekar, Ranjit; Yerlikaya, Gülen; Tzelepis, Thanasis; Nicolaides, Kypros H.

doi:10.1002/uog.17289

Cited by 37 publications

(31 citation statements)

References 16 publications

(19 reference statements)

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“…Reports on the capability of PlGF to predict SGA have been conflicting. Initial small case–control studies in the first and second trimesters for the prediction of SGA found no significant relationship, but subsequent larger case–control studies and several prospective cohorts measuring PlGF in the second and first trimesters have reported an association between low PlGF concentrations and early‐onset pre‐eclampsia, stillbirth and SGA. The few small ( n = 21 or fewer), mainly case–control studies in which measurement was undertaken in the third trimester (including at time of delivery), generally concur with our finding of low PlGF concentration in women with subsequent delivery of a SGA infant, particularly those with significant underlying placental pathology.…”

Section: Discussionsupporting

confidence: 80%

Predicting delivery of a small‐for‐gestational‐age infant and adverse perinatal outcome in women with suspected pre‐eclampsia

Griffin

Seed

Duckworth

et al. 2018

Ultrasound in Obstet & Gyne

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ObjectiveTo evaluate the test performance of 47 biomarkers and ultrasound parameters for the prediction of delivery of a small‐for‐gestational‐age (SGA) infant and adverse perinatal outcome in women presenting with suspected pre‐eclampsia.MethodsThis was a prospective, multicenter observational study in which 47 biomarkers and ultrasound parameters were measured in 397 women with a singleton pregnancy presenting with suspected preterm pre‐eclampsia between 20 + 0 and 36 + 6 weeks' gestation, with the objective of evaluating them as predictors of subsequent delivery of a SGA infant and adverse perinatal outcome. Women with confirmed pre‐eclampsia at enrollment were excluded. Factor analysis and stepwise logistic regression were performed in two prespecified groups stratified according to gestational age at enrollment. The primary outcome was delivery of a SGA infant with a birth weight < 3rd customized centile (SGA‐3), and secondary outcomes were a SGA infant with a birth weight < 10th customized centile and adverse perinatal outcome.ResultsIn 274 women presenting at 20 + 0 to 34 + 6 weeks' gestation, 96 (35%) delivered a SGA‐3 infant. For prediction of SGA‐3, low maternal placental growth factor (PlGF) concentration had a sensitivity of 93% (95% CI, 84–98%) and negative predictive value (NPV) of 90% (95% CI, 76–97%) compared with a sensitivity of 71% (95% CI, 58–82%) and a NPV of 79% (95% CI, 68–87%) for ultrasound parameters (estimated fetal weight or abdominal circumference < 10th centile). No individual biomarker evaluated had a better performance than did PlGF, and marker combinations made only small improvements to the test performance. Similar results were found in 123 women presenting between 35 + 0 and 36 + 6 weeks' gestation.ConclusionIn women presenting with suspected preterm pre‐eclampsia, measurement of PlGF offers a useful adjunct for identifying those at high risk of delivering a SGA infant, allowing appropriate surveillance and timely intervention. © 2017 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.

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Section: Discussionsupporting

confidence: 80%

Predicting delivery of a small‐for‐gestational‐age infant and adverse perinatal outcome in women with suspected pre‐eclampsia

Griffin

Seed

Duckworth

et al. 2018

Ultrasound in Obstet & Gyne

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“…Previous studies reported that, at 11–13 weeks' gestation, serum PlGF is reduced in pregnancies with impaired placentation resulting in PE or the birth of an SGA neonate. The performance of early screening for stillbirth due to impaired placentation by an algorithm that incorporates serum PlGF is superior to that relying on maternal factors alone or a combination of maternal factors with UtA‐PI, DV‐PIV and serum PAPP‐A. This is not surprising since we have reported previously that, in early screening for PE by a combination of maternal factors and biomarkers, serum PlGF had a better performance than did serum PAPP‐A.…”

Section: Discussionmentioning

confidence: 68%

Prediction of stillbirth from placental growth factor at 11–13 weeks

Akolekar

Machuca

Mendes

et al. 2016

Ultrasound in Obstet & Gyne

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“…Accurate prediction of term stillbirth and other adverse outcomes that may be prevented from earlier delivery will require a paradigm shift in the assessment of stillbirth risk. Traditional approaches based on maternal risk factors, fetal growth assessments, and ancillary ultrasound tools such as fetoplacental Doppler studies perform poorly for term outcomes compared to preterm outcomes [30][31][32][33][34]. Placental function biomarkers have not yet been clinically useful but are a potential source of benefit in the future [35][36][37].…”

Section: Challenges To the Safe Deferral Of Late Preterm And Early Tementioning

confidence: 99%

Is it possible to safely prevent late preterm and early term births?

White

Newnham

2019

Seminars in Fetal and Neonatal Medicine

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Prediction of stillbirth from biochemical and biophysical markers at 11–13 weeks

Cited by 37 publications

References 16 publications

Predicting delivery of a small‐for‐gestational‐age infant and adverse perinatal outcome in women with suspected pre‐eclampsia

Predicting delivery of a small‐for‐gestational‐age infant and adverse perinatal outcome in women with suspected pre‐eclampsia

Prediction of stillbirth from placental growth factor at 11–13 weeks

Is it possible to safely prevent late preterm and early term births?

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