Sherrell Helen, Dunn Liam, Clifton Vicki, Kumar Sailesh
Mater Research Institute, University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, Queensland, QLD 4101, Australia.
Mater Research Institute, University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, Queensland, QLD 4101, Australia; Mater Mothers' Hospital, Raymond Terrace, South Brisbane, Queensland, QLD 4101, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Australia.
Eur J Obstet Gynecol Reprod Biol. 2018 Jun;225:26-34. doi: 10.1016/j.ejogrb.2018.03.059. Epub 2018 Mar 30.
This systematic review evaluates the utility of maternal Placental Growth Factor (PlGF) when measured in late pregnancy (>20 weeks) as a predictor of adverse obstetric and perinatal outcomes.
Pubmed and Embase were searched using the term "placental growth factor" in combination with relevant perinatal outcomes. Studies were included if they measured PlGF levels in pregnant women after 20 + 0 weeks gestation and reported relevant adverse obstetric or perinatal outcomes related to placental insufficiency (excluding pre-eclampsia).
Twenty-six studies were eligible for inclusion with 21 studies investigating the relationship between PlGF and small for gestational age (SGA) and 7 studies investigating PlGF for the prediction of other adverse perinatal outcomes. In all studies, maternal PlGF levels were significantly lower in the SGA group compared to controls. Other outcomes investigated included caesarean section (CS) for fetal compromise, low Apgar score, neonatal intensive care unit (NICU) admission, neonatal acidosis, stillbirth, and intrapartum fetal compromise. The results generally showed a significant association between low PlGF levels and CS for fetal compromise, NICU admission and stillbirth.
Low maternal PlGF levels in late pregnancy are strongly associated with SGA. Findings across studies were variable in relation to PlGF and the prediction of other adverse intrapartum and perinatal outcomes, however there was a consistent association between low PlGF levels and CS for fetal compromise, NICU admission and stillbirth. This review suggests that the use of PlGF for the prediction of adverse outcomes is promising. Its predictive value may potentially be enhanced if used in combination with other biomarkers or biophysical measures of fetal well-being.
本系统评价旨在评估妊娠晚期（>20周）测量孕妇胎盘生长因子（PlGF）作为不良产科和围产期结局预测指标的效用。
在PubMed和Embase数据库中检索，使用“胎盘生长因子”一词并结合相关围产期结局。纳入的研究需测量妊娠20 + 0周后孕妇的PlGF水平，并报告与胎盘功能不全相关的不良产科或围产期结局（不包括子痫前期）。
26项研究符合纳入标准，其中21项研究调查了PlGF与小于胎龄儿（SGA）之间的关系，7项研究调查了PlGF对其他不良围产期结局的预测作用。在所有研究中，SGA组孕妇的PlGF水平显著低于对照组。其他调查的结局包括因胎儿窘迫行剖宫产（CS）、低Apgar评分、新生儿重症监护病房（NICU）入院、新生儿酸中毒、死产和产时胎儿窘迫。结果总体显示，低PlGF水平与因胎儿窘迫行CS、NICU入院和死产之间存在显著关联。
妊娠晚期孕妇PlGF水平低与SGA密切相关。关于PlGF与其他不良产时和围产期结局预测的研究结果存在差异，然而，低PlGF水平与因胎儿窘迫行CS、NICU入院和死产之间存在一致的关联。本综述表明，使用PlGF预测不良结局具有前景。如果与其他生物标志物或胎儿健康的生物物理指标联合使用，其预测价值可能会提高。
