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Published on: June 29, 2013
Prediction of Fetal Growth Restriction Using Serum PlGF Combined with PAPP-A in Early Pregnancy
1Department of Obstetrics, The Third Affiliated Hospital of Guangxi Medical University, The Second Nanning People's Hospital, Nanning, Guangxi, 530031, People's Republic of China.
Insights
Early pregnancy screening for fetal growth restriction (FGR) can be improved using placenta growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) serum levels. Combined testing offers slightly better predictive accuracy for early FGR detection.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Biomarker Discovery
Background:
- Fetal growth restriction (FGR) is a major cause of perinatal morbidity and mortality.
- Early detection of FGR is crucial for timely intervention and improved pregnancy outcomes.
Purpose of the Study:
- To evaluate the predictive capability of serum placenta growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) levels for FGR.
- To assess the combined predictive value of PlGF and PAPP-A in early pregnancy.
Main Methods:
- Retrospective cohort study of 1602 pregnant women.
- Serum PlGF and PAPP-A levels measured at 11-13+6 weeks gestation.
- Comparison of biomarker levels between FGR and normal control groups using statistical tests and ROC curve analysis.
Main Results:
- The incidence of FGR was 5.86%.
- Significantly lower serum PlGF and PAPP-A levels were observed in the FGR group (p<0.05).
- Both PlGF (AUC=0.734) and PAPP-A (AUC=0.729) showed individual predictive value for FGR; combined use slightly improved prediction (AUC=0.742).
Conclusions:
- Serum PlGF and PAPP-A levels in early pregnancy are effective predictors of FGR.
- Combined assessment of PlGF and PAPP-A enhances predictive accuracy for FGR screening.
- This approach offers a novel method for early FGR detection and management.
Objective:
This study aimed to assess the predictive capacity of placenta growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) levels in the serum of pregnant women during early pregnancy (11-13+6 weeks) for fetal growth restriction (FGR).
Patients And Methods:
A retrospective cohort study was conducted involving 1602 pregnant women who gave birth at The Second Nanning People's Hospital between March 2018 and September 2019. Serum concentrations of PlGF and PAPP-A were measured during early pregnancy for all participants. Based on pregnancy outcomes, participants were categorized into the FGR group (n = 94) and the normal control group (n = 1508). Clinical characteristics, serum PAPP-A, and PlGF levels during early pregnancy (11-13+6 weeks) were compared between the two groups using t-tests and one-way analysis of variance. Receiver operating characteristic (ROC) curves were generated to assess the predictive value of each biomarker.
Results:
The overall incidence of FGR in the study cohort was 5.86%. Pregnant women in the FGR group exhibited significantly lower serum levels of PlGF and PAPP-A compared to the control group (both p<0.05). Correlation analysis revealed that PAPP-A levels were inversely associated with maternal age, pre-pregnancy body mass index (BMI), platelet count, and fibrinogen (all p<0.05). ROC analysis demonstrated that the area under the curve (AUC) for predicting FGR was 0.734 (95% CI: 0.677-0.790) for PlGF and 0.729 (95% CI: 0.676-0.781) for PAPP-A, which indicates a certain individual predictive value. When combined, the predictive efficiency slightly improved (AUC=0.742).
Conclusion:
Serum levels of PlGF and PAPP-A in early pregnancy can effectively predict FGR, with slightly improved predictive accuracy when used together, presenting a new method for early FGR screening.
