Bligh Larissa N, Greer Ristan M, Kumar Sailesh
Mater Research Institute - University of Queensland, South Brisbane, QLD, and Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston, QLD, Australia.
Fetal Diagn Ther. 2018;44(3):194-201. doi: 10.1159/000480381. Epub 2017 Oct 11.
Fetuses who fail to reach their genetic growth potential are thought to have sub-optimal placental function. Low placental growth factor (PlGF) levels have been shown to be predictive of placentally mediated conditions, such as pre-eclampsia or fetal growth restriction. We investigated the screening performance of PlGF for the prediction of low birth weight (<10th centile for gestation) and adverse intrapartum and neonatal outcomes in apparently low-risk term pregnancies.
Maternal PlGF levels were measured fortnightly in a blinded, prospective, observational study from 36 weeks of pregnancy. Women and clinicians were blinded to PlGF results, and pregnancies were managed according to local policies and guidelines. Intrapartum and neonatal outcomes were recorded. PlGF was analysed for association with, and predictive capacity for, low birth weight, caesarean section for intrapartum fetal compromise (CS-IFC) and adverse neonatal outcomes.
A total of 438 women were included in the final analysis. Lower PlGF levels were associated with low birth weight, CS-IFC and adverse neonatal outcome. For a false-positive rate of 10 and 20%, respectively, the corresponding sensitivities were 9.7-11.1% and 22.2-26.8%.
As a sole predictor for low birth weight, CS-IFC and adverse neonatal outcome, PlGF was poor as a test.
未能达到其遗传生长潜力的胎儿被认为胎盘功能欠佳。胎盘生长因子（PlGF）水平低已被证明可预测由胎盘介导的病症，如先兆子痫或胎儿生长受限。我们研究了PlGF对预测足月低风险妊娠中低出生体重（<妊娠第10百分位数）以及不良产时和新生儿结局的筛查性能。
在一项前瞻性观察性双盲研究中，从妊娠36周起每两周测量一次孕妇的PlGF水平。孕妇和临床医生对PlGF结果不知情，妊娠按照当地政策和指南进行管理。记录产时和新生儿结局。分析PlGF与低出生体重、因产时胎儿窘迫行剖宫产（CS-IFC）及不良新生儿结局之间的关联及预测能力。
最终分析纳入了438名女性。较低的PlGF水平与低出生体重、CS-IFC及不良新生儿结局相关。对于假阳性率分别为10%和20%的情况，相应的敏感度分别为9.7 - 11.1%和22.2 - 26.8%。
作为低出生体重、CS-IFC及不良新生儿结局的唯一预测指标，PlGF作为一项检测指标效果不佳。
