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Published on: August 2, 2017
Screening for pre-eclampsia with competing-risks model using placental growth factor measurement in blood samples
I Riishede1,2, C K Ekelund1,2, L Sperling3,4
1Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Insights
Placental growth factor (PlGF) levels in blood samples collected before 10 weeks of gestation are not reliable for predicting pre-eclampsia (PE). However, PlGF measurements at 10 weeks show lower levels in preterm PE cases.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Biomarker Research
Background:
- Pre-eclampsia (PE) is a major cause of maternal and fetal morbidity.
- Early prediction of PE is crucial for timely intervention and improved outcomes.
- Placental growth factor (PlGF) is a known biomarker for PE, but its utility in early gestation requires further investigation.
Purpose of the Study:
- To evaluate the predictive performance of placental growth factor (PlGF) in blood samples collected before 11 weeks of gestation for pre-eclampsia (PE).
- To describe the distributional properties of PlGF in early pregnancy for PE risk assessment.
Main Methods:
- Analysis of serum PlGF concentrations from routine combined first-trimester screening (cFTS) blood samples (8-14 weeks gestation) within the Pre-eclampsia Screening in Denmark (PRESIDE) study.
- Inclusion of 8386 pregnant women in the prospective multicenter study.
- Utilizing the Fetal Medicine Foundation (FMF) first-trimester screening algorithm for PE prediction.
Main Results:
- PlGF multiples of the median (MoM) were significantly lower in pregnancies with preterm PE (<37 weeks) when samples were collected at 10 weeks gestation.
- No significant difference in PlGF MoM was observed between PE and unaffected pregnancies for samples collected before 10 weeks gestation.
- The overall incidence of PE was 0.7% for preterm PE (<37 weeks) and 3.0% for term PE (≥37 weeks).
Conclusions:
- The gestational-age range for PlGF sampling in PE risk assessment using the FMF model can be expanded to 10-14 weeks.
- There is limited evidence supporting the use of PlGF in blood samples collected prior to 10 weeks gestation for PE prediction.
- Early PlGF measurements before 10 weeks are not recommended for pre-eclampsia screening.
Objectives:
To describe the distributional properties and assess the performance of placental growth factor (PlGF) measured in blood samples collected before 11 weeks' gestation in the prediction of pre-eclampsia (PE).
Methods:
The study population consisted of pregnant women included in the Pre-eclampsia Screening in Denmark (PRESIDE) study with a PlGF measurement from the routine combined first-trimester screening (cFTS) blood sample collected at 8-14 weeks' gestation. PRESIDE was a prospective multicenter study investigating the predictive performance of the Fetal Medicine Foundation (FMF) first-trimester screening algorithm for PE in a Danish population. In the current study, serum concentration of PlGF in the cFTS blood samples was analyzed in batches between January and June 2021.
Results:
A total of 8386 pregnant women were included. The incidence of PE was 0.7% at < 37 weeks' gestation and 3.0% at ≥ 37 weeks. In blood samples collected at 10 weeks' gestation, PlGF multiples of the median (MoM) were significantly lower in pregnancies with preterm PE < 37 weeks compared to unaffected pregnancies. However, PlGF MoM did not differ significantly between pregnancies with PE and unaffected pregnancies in samples collected before 10 weeks' gestation.
Conclusions:
The gestational-age range for PlGF sampling may be expanded from 11-14 to 10-14 weeks when assessing the risk for PE using the FMF first-trimester screening model. There is little evidence to support the use of PlGF in blood samples collected before 10 weeks' gestation. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
