Implementation of Placental Growth Factor in a Tertiary Western Canadian Centre: Association with Ultrasound Findings...

This study aimed to evaluate the association between placental growth factor (PlGF) levels, ultrasound findings, and perinatal outcomes in a high-risk pregnant population at a tertiary referral centre in Western Canada, and to assess the predictive performance of the PlGF test.

We conducted a retrospective cohort study of 389 high-risk pregnant individuals who underwent PlGF testing between 12⁰ and 36⁰ weeks gestation. Participants were stratified by PlGF level: normal (≥10th centile), inconclusive (5th-9th centile), and low (≤5th centile). Clinical, biochemical, ultrasound, and perinatal outcomes were compared across groups. Odds ratios, sensitivity, specificity, and predictive values were calculated.

Low PlGF levels were observed in 33.9% of pregnancies, with testing performed at a median gestational age of 27⁶ weeks. Low PlGF levels were significantly associated with higher maternal BMI, elevated blood pressure, and increased creatinine, uric acid, and proteinuria levels. Ultrasound findings in the low PlGF group revealed higher rates of fetal growth restriction, abnormal Doppler studies, and abnormal placental morphology. These pregnancies had increased incidence of preterm birth <34⁰ weeks (52/132; 39.3%), preeclampsia (69/132; 52.3%), neonatal intensive care unit admission (54/132; 40.9%), and small-for-gestational-age neonates (15/132; 11.4%). Most negative predictive values exceeded 90%.

Low maternal PlGF levels are strongly associated with ultrasound and biochemical indicators of placental dysfunction and adverse perinatal outcomes. PlGF testing may serve as an effective risk stratification tool in high-risk pregnancies, particularly in rural and underserved populations.