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Use of first‐trimester placenta growth factor concentration to predict hypertensive disorders of pregnancy in a low‐risk Asian population
Author(s) -
Kumar Manisha,
Sharma Karuna,
Singh Shalini,
Singh Ritu,
Singh Abha,
Bhattacharjee Jayashree
Publication year - 2017
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12301
Subject(s) - medicine , uterine artery , body mass index , confidence interval , odds ratio , pregnancy , obstetrics , receiver operating characteristic , population , prospective cohort study , area under the curve , biomarker , risk factor , gynecology , gestation , biochemistry , chemistry , genetics , environmental health , biology
Objective To determine the value of placenta growth factor (Pl GF ) for predicting hypertensive disorders of pregnancy ( HDP ) in a low‐risk population when used either alone or in combination with other markers. Methods A prospective observational cohort study was conducted among women with singleton pregnancy in the first trimester in New Delhi, India, between October 1, 2013, and September 30, 2016. First‐trimester measures included maternal history, body mass index ( BMI ), mean arterial pressure ( MAP ), Doppler uterine artery pulsatility index, and serum levels of biomarkers (including Pl GF ). Results Among 1725 women, 208 (12.1%) developed HDP ; 74 (35.6%) of these cases were early onset. Mean Pl GF levels were significantly lower among cases than among controls (30.42 ± 10.22 vs 37.31 ± 13.28 pg/ mL ; P< 0.001). As a biomarker for prediction of HDP , Pl GF fared better than pregnancy‐associated plasma protein A ( PAPP ‐A): area under the curve 0.685 (95% confidence interval [ CI ] 0.620–0.750; P< 0.001) versus 0.659 (95% CI 0.593–0.726; P< 0.001). The highest odds ratio was found for MAP (8.369, 95% CI 5.752–12.215). The combination of Pl GF , PAPP ‐A, BMI , MAP , and Doppler uterine artery pulsatility index provided an area under the receiver operating characteristic curve of 0.876 (95% CI 0.833–0.919; P< 0.001). Conclusion Combining Pl GF concentration with biochemical and biophysical markers provided a good screening test for HDP during the first trimester.