Department of Pediatrics, Peking University People's Hospital, Beijing, China.
Department of Gynaecology and Obstetrics, Peking University People's Hospital, Beijing, China.
J Matern Fetal Neonatal Med. 2024 Dec;37(1):2428387. doi: 10.1080/14767058.2024.2428387. Epub 2024 Nov 17.
At present, research has not found easily accessible, accurate, and safe clinical biomarkers that can effectively predict the occurrence of infants born small for gestational age (SGA). The aim of this study is to explore the predictive role of maternal placental growth factor (PIGF) levels on the occurrence of SGA infants.
We conducted a matched case-control study on 226 SGA infants and 226 non-SGA infants born in the Department of Obstetrics, Peking University People's Hospital, from January 2021 to December 2022, with regular monitoring of maternal serum PIGF levels in second trimester during pregnancy. Apply multiple logistic regression analysis and receiver operating characteristic (ROC) curve analysis to determine whether PIGF is an independent influencing factor for the occurrence of SGA in infants, and evaluate whether PIGF can predict the occurrence of SGA in infants.
Multiple logistic regression analysis found that multipara (HR = 0.484, 95% CI = 0.250-0.937, = 0.031), maternal pre-pregnancy underweight (HR = 4.710, 95% CI = 1.881-11.792, = 0.001), pre-eclampsia(HR = 2.291, 95% CI = 1.068-4.913, = 0.033), low levels of PIGF (HR = 26.417, 95% CI = 12.850-54.311, < 0.001) and oligohydramnios (HR = 4.764, 95% CI = 1.845-12.301, = 0.001) were independent factors affecting the occurrence of infants born SGA. In addition, ROC curve analysis showed that the area under the curve (AUC) predicted by PIGF level and four other influencing factors for the occurrence of SGA infants were 0.834 and 0.723, respectively. In addition, the combination of PIGF and four other independent influencing factors improved the predictive value (AUC 0.902) for the birth of SGA infants, with enhanced sensitivity and specificity.
Low levels of PIGF in second trimester during pregnancy are an independent risk factor for SGA infants. Compared with other indicators, PIGF levels PIGF in second trimester are a better predictor of SGA in infants.
目前，研究尚未发现易于获取、准确且安全的临床生物标志物，能够有效预测胎儿生长受限（SGA）的发生。本研究旨在探讨母体胎盘生长因子（PIGF）水平对 SGA 婴儿发生的预测作用。
我们对 2021 年 1 月至 2022 年 12 月在北京大学人民医院妇产科出生的 226 例 SGA 婴儿和 226 例非 SGA 婴儿进行了匹配病例对照研究，对孕妇妊娠中期的血清 PIGF 水平进行了常规监测。采用多因素逻辑回归分析和受试者工作特征（ROC）曲线分析，确定 PIGF 是否为婴儿 SGA 发生的独立影响因素，并评估 PIGF 能否预测婴儿 SGA 的发生。
多因素逻辑回归分析发现，经产妇（HR=0.484，95%CI=0.250-0.937，P=0.031）、孕妇孕前低体重（HR=4.710，95%CI=1.881-11.792，P=0.001）、子痫前期（HR=2.291，95%CI=1.068-4.913，P=0.033）、低水平的 PIGF（HR=26.417，95%CI=12.850-54.311，P<0.001）和羊水过少（HR=4.764，95%CI=1.845-12.301，P=0.001）是影响 SGA 婴儿发生的独立因素。此外，ROC 曲线分析显示，PIGF 水平和预测 SGA 婴儿发生的其他四个影响因素的曲线下面积（AUC）分别为 0.834 和 0.723。此外，PIGF 与其他四个独立影响因素的组合提高了对 SGA 婴儿出生的预测价值（AUC 0.902），具有更高的敏感性和特异性。
妊娠中期 PIGF 水平降低是 SGA 婴儿的独立危险因素。与其他指标相比，妊娠中期 PIGF 水平是 SGA 婴儿更好的预测指标。
