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  • Spencer, RebeccaLeeds School of Medicine,University College London (author)

Maternal PlGF and umbilical Dopplers predict pregnancy outcomes at diagnosis of early-onset fetal growth restriction

  • Article/chapterEnglish2023

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  • 2023

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  • LIBRIS-ID:oai:lup.lub.lu.se:1602864e-77b9-4c50-ade3-b7946e287888
  • https://lup.lub.lu.se/record/1602864e-77b9-4c50-ade3-b7946e287888URI
  • https://doi.org/10.1172/JCI169199DOI

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  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

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  • BACKGROUND. Severe, early-onset fetal growth restriction (FGR) causes significant fetal and neonatal mortality and morbidity. Predicting the outcome of affected pregnancies at the time of diagnosis is difficult, thus preventing accurate patient counseling. We investigated the use of maternal serum protein and ultrasound measurements at diagnosis to predict fetal or neonatal death and 3 secondary outcomes: fetal death or delivery at or before 28+0 weeks, development of abnormal umbilical artery (UmA) Doppler velocimetry, and slow fetal growth. METHODS. Women with singleton pregnancies (n = 142, estimated fetal weights [EFWs] below the third centile, less than 600 g, 20+0 to 26+6 weeks of gestation, no known chromosomal, genetic, or major structural abnormalities) were recruited from 4 European centers. Maternal serum from the discovery set (n = 63) was analyzed for 7 proteins linked to angiogenesis, 90 additional proteins associated with cardiovascular disease, and 5 proteins identified through pooled liquid chromatography and tandem mass spectrometry. Patient and clinician stakeholder priorities were used to select models tested in the validation set (n = 60), with final models calculated from combined data. RESULTS. The most discriminative model for fetal or neonatal death included the EFW z score (Hadlock 3 formula/Marsal chart), gestational age, and UmA Doppler category (AUC, 0.91; 95% CI, 0.86-0.97) but was less well calibrated than the model containing only the EFW z score (Hadlock 3/Marsal). The most discriminative model for fetal death or delivery at or before 28+0 weeks included maternal serum placental growth factor (PlGF) concentration and UmA Doppler category (AUC, 0.89; 95% CI, 0.83-0.94). CONCLUSION. Ultrasound measurements and maternal serum PlGF concentration at diagnosis of severe, early-onset FGR predicted pregnancy outcomes of importance to patients and clinicians.

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  • Maksym, KasiaUniversity College London (author)
  • Hecher, KurtUniversity Medical Center Hamburg-Eppendorf (author)
  • Maršál, KarelLund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Tornbladinstitutet,Forskargrupper vid Lunds universitet,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Tornblad Institute,Lund University Research Groups,Skåne University Hospital(Swepub:lu)gyn-kma (author)
  • Figueras, FrancescUniversity of Barcelona (author)
  • Ambler, GarethUniversity College London (author)
  • Whitwell, HarryImperial College London,University College London (author)
  • Nené, Nuno RochaUniversity College London (author)
  • Sebire, Neil J.UCL Institute of Child Health (author)
  • Hansson, Stefan R.Lund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Enheten för translationell obstetrisk forskning,Forskargrupper vid Lunds universitet,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Unit for translational obstetric research,Lund University Research Groups,Skåne University Hospital(Swepub:lu)gyn-sha (author)
  • Diemert, AnkeUniversity Medical Center Hamburg-Eppendorf (author)
  • Brodszki, JanaLund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)gyn-jko (author)
  • Gratacós, EduardUniversity of Barcelona (author)
  • Ginsberg, YuvalRambam Medical Center,University College London (author)
  • Weissbach, TalSheba Medical Center,University College London (author)
  • Peebles, Donald M.University College London (author)
  • Zachary, IanUniversity College London (author)
  • Marlow, NeilUniversity College London (author)
  • Huertas-Ceballos, AngelaUniversity College London Hospital (author)
  • David, Anna L.University College London (author)
  • Leeds School of MedicineUniversity College London (creator_code:org_t)

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  • In:Journal of Clinical Investigation133:180021-9738

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