Department of Obstetrics and Gynecology, Lady Hardinge Medical College, New Delhi, India.
Department of Biochemistry, Lady Hardinge Medical College, New Delhi, India.
Int J Gynaecol Obstet. 2017 Dec;139(3):301-306. doi: 10.1002/ijgo.12301. Epub 2017 Sep 13.
To determine the value of placenta growth factor (PlGF) for predicting hypertensive disorders of pregnancy (HDP) in a low-risk population when used either alone or in combination with other markers.
A prospective observational cohort study was conducted among women with singleton pregnancy in the first trimester in New Delhi, India, between October 1, 2013, and September 30, 2016. First-trimester measures included maternal history, body mass index (BMI), mean arterial pressure (MAP), Doppler uterine artery pulsatility index, and serum levels of biomarkers (including PlGF).
Among 1725 women, 208 (12.1%) developed HDP; 74 (35.6%) of these cases were early onset. Mean PlGF levels were significantly lower among cases than among controls (30.42 ± 10.22 vs 37.31 ± 13.28 pg/mL; P<0.001). As a biomarker for prediction of HDP, PlGF fared better than pregnancy-associated plasma protein A (PAPP-A): area under the curve 0.685 (95% confidence interval [CI] 0.620-0.750; P<0.001) versus 0.659 (95% CI 0.593-0.726; P<0.001). The highest odds ratio was found for MAP (8.369, 95% CI 5.752-12.215). The combination of PlGF, PAPP-A, BMI, MAP, and Doppler uterine artery pulsatility index provided an area under the receiver operating characteristic curve of 0.876 (95% CI 0.833-0.919; P<0.001).
Combining PlGF concentration with biochemical and biophysical markers provided a good screening test for HDP during the first trimester.
在低危人群中，单独或联合其他标志物使用胎盘生长因子（PlGF）预测妊娠高血压疾病（HDP）的价值。
本前瞻性观察性队列研究于 2013 年 10 月 1 日至 2016 年 9 月 30 日在印度新德里的单胎妊娠初产妇中进行。初产妇的指标包括母亲病史、体重指数（BMI）、平均动脉压（MAP）、子宫动脉多普勒搏动指数以及生物标志物（包括 PlGF）的血清水平。
在 1725 名女性中，有 208 名（12.1%）发生 HDP；其中 74 例（35.6%）为早发型。病例组的平均 PlGF 水平明显低于对照组（30.42±10.22 比 37.31±13.28 pg/mL；P<0.001）。作为 HDP 预测的生物标志物，PlGF 优于妊娠相关血浆蛋白 A（PAPP-A）：曲线下面积 0.685（95%置信区间 [CI] 0.620-0.750；P<0.001）与 0.659（95% CI 0.593-0.726；P<0.001）。MAP 发现的最高比值为 8.369（95% CI 5.752-12.215）。PlGF、PAPP-A、BMI、MAP 和子宫动脉多普勒搏动指数的联合使用提供了 0.876（95% CI 0.833-0.919；P<0.001）的接收者操作特征曲线下面积。
PlGF 浓度与生化和生物物理标志物相结合，为 HDP 提供了一种良好的初筛试验。
