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Objectives  To assess the diagnostic accuracy of placental growth factor ( PlGF ) and ultrasound parameters to predict delivery of a small‐for‐gestational‐age ( SGA ) infant in women presenting with reduced symphysis–fundus height ( SFH ).    Methods  This was a multicenter prospective observational study recruiting 601 women with a singleton pregnancy and reduced  SFH  between 24 and 37 weeks' gestation across 11 sites in the  UK  and Canada. Plasma  PlGF  concentration < 5 th  centile, estimated fetal weight ( EFW ) < 10 th  centile, umbilical artery Doppler pulsatility index > 95 th  centile and oligohydramnios (amniotic fluid index < 5 cm) were compared as predictors for a  SGA  infant < 3 rd  customized birth‐weight centile and adverse perinatal outcome. Test performance statistics were calculated for all parameters in isolation and in combination.    Results  Of the 601 women recruited, 592 were analyzed. For predicting delivery of  SGA  < 3 rd  centile ( n  = 78),  EFW  < 10 th  centile had 58% sensitivity (95%  CI , 46–69%) and 93% negative predictive value ( NPV ) (95%  CI , 90–95%),  PlGF  had 37% sensitivity (95%  CI , 27–49%) and 90%  NPV  (95%  CI , 87–93%); in combination,  PlGF  and  EFW  < 10 th  centile had 69% sensitivity (95%  CI , 55–81%) and 93%  NPV  (95%  CI , 89–96%). The equivalent receiver–operating characteristics ( ROC ) curve areas were 0.79 (95%  CI , 0.74–0.84) for  EFW  < 10 th  centile, 0.70 (95%  CI , 0.63–0.77) for low  PlGF  and 0.82 (95%  CI , 0.77–0.86) in combination.    Conclusions  For women presenting with reduced  SFH , ultrasound parameters had modest test performance for predicting delivery of  SGA  < 3 rd  centile.  PlGF  performed no better than  EFW  < 10 th  centile in determining delivery of a  SGA  infant. © 2015 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the international society of ultrasound in obstetrics and gynecology.

ultrasound in obstetrics and gynecology

Diagnostic accuracy of placental growth factor and ultrasound parameters to predict the small‐for‐gestational‐age infant in women presenting with reduced symphysis–fundus height