Use of first-trimester placenta growth factor concentration to predict hypertensive disorders of pregnancy in a low-risk Asian population.
OBJECTIVE
To determine the value of placenta growth factor (PlGF) for predicting hypertensive disorders of pregnancy (HDP) in a low-risk population when used either alone or in combination with other markers.


METHODS
A prospective observational cohort study was conducted among women with singleton pregnancy in the first trimester in New Delhi, India, between October 1, 2013, and September 30, 2016. First-trimester measures included maternal history, body mass index (BMI), mean arterial pressure (MAP), Doppler uterine artery pulsatility index, and serum levels of biomarkers (including PlGF).


RESULTS
Among 1725 women, 208 (12.1%) developed HDP; 74 (35.6%) of these cases were early onset. Mean PlGF levels were significantly lower among cases than among controls (30.42 ± 10.22 vs 37.31 ± 13.28 pg/mL; P<0.001). As a biomarker for prediction of HDP, PlGF fared better than pregnancy-associated plasma protein A (PAPP-A): area under the curve 0.685 (95% confidence interval [CI] 0.620-0.750; P<0.001) versus 0.659 (95% CI 0.593-0.726; P<0.001). The highest odds ratio was found for MAP (8.369, 95% CI 5.752-12.215). The combination of PlGF, PAPP-A, BMI, MAP, and Doppler uterine artery pulsatility index provided an area under the receiver operating characteristic curve of 0.876 (95% CI 0.833-0.919; P<0.001).


CONCLUSION
Combining PlGF concentration with biochemical and biophysical markers provided a good screening test for HDP during the first trimester.
['Kumar|Manisha|M|', 'Sharma|Karuna|K|', 'Singh|Shalini|S|', 'Singh|Ritu|R|', 'Singh|Abha|A|', 'Bhattacharjee|Jayashree|J|']
D000328:Adult D062186:Arterial Pressure D015415:Biomarkers D015992:Body Mass Index D005260:Female D006801:Humans D007194:India D000072483:Placenta Growth Factor D011225:Pre-Eclampsia D011237:Predictive Value of Tests D011247:Pregnancy D011261:Pregnancy Trimester, First D011296:Prenatal Diagnosis D011446:Prospective Studies D011673:Pulsatile Flow D012372:ROC Curve D012307:Risk Factors D055988:Uterine Artery D055815:Young Adult
Placenta growth factor First trimester Body mass index Doppler Biomarkers Pre-eclampsia