Prediction of Fetal Growth Restriction Using Serum PlGF Combined with PAPP-A in Early Pregnancy.

OBJECTIVE

This study aimed to assess the predictive capacity of placenta growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) levels in the serum of pregnant women during early pregnancy (11-13 weeks) for fetal growth restriction (FGR).

PATIENTS AND METHODS

A retrospective cohort study was conducted involving 1602 pregnant women who gave birth at The Second Nanning People's Hospital between March 2018 and September 2019. Serum concentrations of PlGF and PAPP-A were measured during early pregnancy for all participants. Based on pregnancy outcomes, participants were categorized into the FGR group (n = 94) and the normal control group (n = 1508). Clinical characteristics, serum PAPP-A, and PlGF levels during early pregnancy (11-13 weeks) were compared between the two groups using -tests and one-way analysis of variance. Receiver operating characteristic (ROC) curves were generated to assess the predictive value of each biomarker.

RESULTS

The overall incidence of FGR in the study cohort was 5.86%. Pregnant women in the FGR group exhibited significantly lower serum levels of PlGF and PAPP-A compared to the control group (both <0.05). Correlation analysis revealed that PAPP-A levels were inversely associated with maternal age, pre-pregnancy body mass index (BMI), platelet count, and fibrinogen (all <0.05). ROC analysis demonstrated that the area under the curve (AUC) for predicting FGR was 0.734 (95% CI: 0.677-0.790) for PlGF and 0.729 (95% CI: 0.676-0.781) for PAPP-A, which indicates a certain individual predictive value. When combined, the predictive efficiency slightly improved (AUC=0.742).

CONCLUSION

Serum levels of PlGF and PAPP-A in early pregnancy can effectively predict FGR, with slightly improved predictive accuracy when used together, presenting a new method for early FGR screening.