Materno-fetal outcome with PlGF above or below cutoff during second half of pregnancy in high-risk women.

Low placental growth factor levels at specific gestational ages are associated with increased risks of complications in high-risk pregnancies.

Summary and findings

This study evaluated the materno-fetal outcomes in high-risk women using placental growth factor (PlGF) levels. The study included 287 women with clinically significant risk factors for pre-eclampsia and assessed PlGF at three gestational time points. Findings indicated that low PlGF levels were associated with various complications during pregnancy.

Abstract

<h4>Objective</h4>To evaluate the materno-fetal outcome of high-risk women using placental growth factor (PlGF).<h4>Methods</h4>This prospective cohort study was performed at a tertiary care hospital from September 2019 to April 2022. Women having clinically major or minor high risk factors of pre-eclampsia were included after consent. The placental growth factor (PlGF) was evaluated among high-risk women at 20-22, 28-30, and 34-36 weeks of gestation. They were followed throughout pregnancy until delivery. Materno-fetal outcome was evaluated based on PlGF levels at three different time points. The gestational age specific cutoff was derived. Those with levels below cutoff were taken as cases and those with values above cutoff were considered as controls. The odds of having complications if the PlGF was below cutoff were determined.<h4>Results</h4>Out of 287 high-risk women, 46 (16%) had pre-eclampsia (PE). The derived cutoff of PlGF was 224, 211, and 176 pg/mL at 20-22, 28-30, and 34-36 weeks, respectively. With PlGF below the cutoff at 20-22 weeks the odds of having HELLP syndrome was 15.8, with low PlGF at 28-30 weeks the odds for developing early onset PE was 11.3. Low PlGF was also significantly associated with preterm delivery (P < 0.001) and early onset FGR (P < 0.001). The sensitivity (91.7%) and specificity (78.5%) of PlGF for PE prediction was highest at 28-30 weeks.<h4>Conclusion</h4>Low PlGF at 28-30 weeks was associated with high likelihood of developing early onset PE, and the PlGF cutoff should be gestational age specific.

Limitations

Not reported in abstract.

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