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

Akolekar, Ranjit; Machuca, Mirian; Mendes, M; Paschos, V.; Nicolaides, Kypros H.

doi:10.1002/uog.17288

Cited by 28 publications

(27 citation statements)

References 23 publications

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“…In addition to preeclampsia screening which has achieved much progress, the first-trimester combined multi-marker screenings for other APOs have also been explored in the recent years. index which predicted 42% of all stillbirths and 61% of those due to impaired placentation at a falsepositive rate of 10% [41]. These models for APOs screenings are in the developing stage.…”

Section: Discussionmentioning

confidence: 99%

First-trimester maternal serum alpha-fetoprotein is not a good predictor for adverse pregnancy outcomes: a retrospective study of 3325 cases

Zhang

et al. 2019

Preprint

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Purpose: To investigate the predictive values of first-trimester maternal serum alpha-fetoprotein (MS-AFP) to preterm birth, stillbirth, preeclampsia and small for gestational age (SGA). Methods: We retrospectively reviewed the data on the first-trimester MS-AFP levels and pregnancy outcomes of 3325 singleton pregnant women. The cutoff value of 2.5 multiple of the median (MoM) was used to evaluate the risks of adverse pregnancy outcomes (APOs) regarding MS-AFP. The receiver operating characteristic (ROC) curves were used to evaluate the predictive efficiencies of MS-AFP to these disorders. Results: A total of 181 pregnancies resulted in preterm birth, 32 in stillbirth, 81 in preeclampsia, and 362 in SGA. Compared to women with MS-AFP < 2.5MoM, those with MS-AFP ≥ 2.5MoM had increased risks (odds ratio, 95% confidence interval) of preterm birth (2.53, 1.65~3.88), preeclampsia (3.05, 1.71~5.43) and SGA (1.90, 1.34~2.69), while the risk of stillbirth was not significantly increased (1.33, 0.40~4.41). The areas under ROC curves were 0.572 (P = 0.001), 0.597 (P = 0.060), 0.579 (P = 0.015) and 0.565 (P = 0.000) for preterm birth, stillbirth, preeclampsia and SGA, respectively. Women with MS-AFP ≥ 2.5MoM had an earlier distribution of gestational weeks at delivery (P = 0.004) and a lower distribution of neonatal birth weights (P = 0.000) compared to those with MS-AFP < 2.5MoM, but the actual between-group differences were minuscule. Conclusion: Elevated first-trimester MS-AFP is associated with increased risk of preterm birth, preeclampsia and SGA. However, the predictive efficiencies were low and it is not a good predictor for these APOs.

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Section: Discussionmentioning

confidence: 99%

First-trimester maternal serum alpha-fetoprotein is not a good predictor for adverse pregnancy outcomes: a retrospective study of 3325 cases

Zhang

et al. 2019

Preprint

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“…Prevention of stillbirth due to impaired placentation could potentially be achieved by a two‐stage screening and intervention strategy. The first stage, at 11–13 weeks, would aim at improving placentation through pharmacological interventions such as low‐dose aspirin and pravastatin in the high‐risk group; first‐trimester screening by a combination of maternal factors, UtA‐PI, fetal ductus venosus PI for veins and maternal serum PlGF could detect about 60% of stillbirths due to impaired placentation, at a 10% FPR. The second stage, at 19–24 weeks, would identify a high‐risk group that could benefit from close monitoring for early diagnosis of PE and SGA and appropriate management to prevent stillbirth in such pregnancies; as demonstrated in this study, about 85% of stillbirths could be predicted from combined screening at 20 weeks' gestation.…”

Section: Discussionmentioning

confidence: 99%

“…Maternal serum levels in the first, second and third trimesters are decreased in pregnancies with impaired placentation that develop PE and those that deliver SGA neonates. There is also evidence that measurement of serum PlGF at 11–13 weeks' gestation is useful in predicting stillbirth.…”

Section: Introductionmentioning

confidence: 99%

Prediction of stillbirth from placental growth factor at 19–24 weeks

Aupont

Akolekar

Illian

et al. 2016

Ultrasound in Obstet & Gyne

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“…b A boxplot showing the birth weights of all neonates. Women with MS-AFP ≥ 2.5 MoM had a lower overall distribution of neonatal birth weights (Median test P = 0.000), but the actual difference was minuscule: the medians of the two groups were 3200 and 3050 g respectively positive rate of 10% [42]. These models for APOs screenings are in the developing stage.…”

Section: Discussionmentioning

confidence: 88%

First-trimester maternal serum alpha-fetoprotein is not a good predictor for adverse pregnancy outcomes: a retrospective study of 3325 cases

Zhang

et al. 2020

BMC Pregnancy Childbirth

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Background: It is well known that second-trimester maternal serum alpha-fetoprotein (MS-AFP) is a predictor for adverse pregnancy outcomes (APOs), such as preterm birth, stillbirth, preeclampsia and small for gestational age (SGA). However, it is unknown whether first-trimester MS-AFP is also predictive of APOs. Methods: We retrospectively reviewed the data on the first-trimester MS-AFP levels and pregnancy outcomes of 3325 singleton pregnant women. The cutoff value of 2.5 multiple of the median (MoM) was used to evaluate the risks of APOs regarding MS-AFP. The receiver operating characteristic (ROC) curves were used to evaluate the predictive efficiencies of MS-AFP to these disorders. Results: A total of 181 pregnancies resulted in preterm birth, 32 in stillbirth, 81 in preeclampsia, and 362 in SGA. Compared to women with MS-AFP < 2.5MoM, those with MS-AFP ≥ 2.5MoM had increased risks (odds ratio, 95% confidence interval) of preterm birth (2.53, 1.65~3.88), preeclampsia (3.05, 1.71~5.43) and SGA (1.90, 1.34~2.69), and had an earlier distribution of gestational weeks at delivery (P = 0.004) and a lower distribution of neonatal birth weights (P = 0.000), but the actual between-group differences were minuscule. The areas under ROC curves were 0.572 (P = 0.001), 0.579 (P = 0.015) and 0.565 (P = 0.000) for preterm birth, preeclampsia and SGA, respectively. Subdivisions for the disorders did not obviously improve the performances of MS-AFP. Conclusions: Elevated first-trimester MS-AFP is associated with increased risk of preterm birth, preeclampsia and SGA. However, the predictive efficiencies were low and it is not a good predictor for these APOs.

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

Cited by 28 publications

References 23 publications

First-trimester maternal serum alpha-fetoprotein is not a good predictor for adverse pregnancy outcomes: a retrospective study of 3325 cases

First-trimester maternal serum alpha-fetoprotein is not a good predictor for adverse pregnancy outcomes: a retrospective study of 3325 cases

Prediction of stillbirth from placental growth factor at 19–24 weeks

First-trimester maternal serum alpha-fetoprotein is not a good predictor for adverse pregnancy outcomes: a retrospective study of 3325 cases

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