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First trimester screening for intra‐uterine growth restriction and early‐onset pre‐eclampsia
Author(s) -
Vandenberghe G.,
Mensink I.,
Twisk J. W. R.,
Blankenstein M. A.,
Heijboer A. C.,
van Vugt J. M. G.
Publication year - 2011
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.2807
Subject(s) - medicine , placental growth factor , intrauterine growth restriction , gestational age , area under the curve , obstetrics , pregnancy , pregnancy associated plasma protein a , preeclampsia , eclampsia , receiver operating characteristic , small for gestational age , logistic regression , gestation , first trimester , biology , vascular endothelial growth factor , vegf receptors , genetics
Objective To assess first trimester placental growth factor (PlGF) and pregnancy‐associated plasma protein‐A (PAPP‐A) as screening markers for early‐onset pre‐eclampsia (PE) and intra‐uterine growth restriction (IUGR). Methods PlGF concentration was retrospectively measured in first trimester serum specimens of 23 cases of early‐onset PE (<34 weeks), 26 cases of IUGR (birth weight < 5th centile) and 5 controls per case. Levels were adjusted for gestational age (GA), ethnicity and smoking to obtain multiples of the expected median (MoM). Logistic regression was used to assess PlGF, PAPP‐A and maternal characteristics as potential predictors of early‐onset PE and IUGR. Results PlGF MoM levels were significantly lower in the early‐onset PE group ( P < 0.0001) compared with controls, but not in the IUGR group. PAPP‐A MoM levels were significantly lower in the IUGR group ( P < 0.01) compared with controls but not in the early‐onset PE group. PlGF significantly improved the ability of systolic blood pressure at the first prenatal visit to predict early‐onset PE [achieving a receiver‐operating characteristics curve with area under the curve (AUC) of 0.8]. Combining systolic blood pressure at the first prenatal visit and PlGF did not significantly improve the predictive ability compared with PlGF alone (AUC = 0.83). Conclusion Serum PlGF is an acceptable marker in first trimester screening for early‐onset PE, but a poor marker in screening for IUGR. Screening performance of serum PAPP‐A is poor for both early‐onset PE and IUGR. Copyright © 2011 John Wiley & Sons, Ltd.