Predictive value of placental growth factor level for adverse pregnancy outcome in twin pregnancies at advanced maternal age.

OBJECTIVE

To investigate the predictive value of placental growth factor (PlGF) for adverse pregnancy outcome in twin pregnancies at advanced maternal age.

METHODS

A retrospective analysis was conducted on 387 women with twin pregnancies who delivered at Northwest Women's and Children's Hospital between March 2020 and March 2024. The women were divided into a favorable outcome group (n = 249) and an adverse outcome group (n = 138) based on their pregnancy outcome. Clinical data and laboratory indicators were compared between the two groups. Logistic regression analysis was used to identify independent risk factors for adverse pregnancy outcome. Receiver Operating Characteristic (ROC) curve analysis was performed to evaluate the predictive value of these independent risk factors. Additionally, the interaction between PlGF and other independent risk factors was analyzed.

RESULTS

Significant differences were observed between the favorable and adverse outcome groups in terms of age, pre-pregnancy Body Mass Index (BMI), mode of conception, gestational hypertension, and gestational diabetes (all P < 0.05). Laboratory indicators revealed that the levels of White Blood Cells (WBC), Neutrophils (Neut), Alpha-Fetoprotein (AFP), Beta Human Chorionic Gonadotropin (β-HCG), and 24-hour urine protein quantification were lower in the favorable outcome group, while the levels of Lymphocytes (Lym) and PlGF were higher (all P < 0.05). Multivariate logistic regression analysis identified mode of conception, Neut, Lym, AFP, β-HCG, 24-hour urine protein quantification, and PlGF as independent risk factors for adverse pregnancy outcome (all P < 0.05). The Area Under the Curve (AUC) for PlGF in predicting adverse pregnancy outcomes was 0.874. Furthermore, an interaction was found between PlGF and adverse pregnancy outcome (P < 0.001) as well as between PlGF and 24-hour urine protein level (P = 0.035).

CONCLUSION

PlGF has significant clinical value for predicting adverse pregnancy outcome in twin pregnancies among women of advanced maternal age. Its levels are strongly correlated with pregnancy outcome and may serve as an effective tool for early screening and intervention in high-risk pregnancies.