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Urinary placental growth factor in preeclampsia and fetal growth restriction: An alternative to circulating biomarkers?
Author(s) -
Zhang Kewei,
Zen Monica,
Popovic Nicole L.,
Lee Vincent W.,
Alahakoon Thushari I.
Publication year - 2019
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14038
Subject(s) - placental growth factor , preeclampsia , medicine , urinary system , soluble fms like tyrosine kinase 1 , gestation , pregnancy , endocrinology , andrology , biology , genetics
Aim To correlate plasma and urinary soluble fms‐like tyrosine kinase 1 (sFlt‐1) and placental growth factor (PIGF) in preeclampsia (PE) and fetal growth restriction (FGR) and assess the performance in detecting established disease. Methods A cross‐sectional case–control study recruited 26–40 weeks gestation pregnancies into four clinical groups: normal pregnancy, PE, PE + FGR, and FGR. enzyme‐linked immunosorbent assay (ELISA) measurements of urinary and plasma sFlt‐1 and PlGF levels were performed. Urinary levels of sFlt‐1 and PIGF were normalized to creatinine. Spearman's rank correlation was used to assess the association between plasma and urinary levels of sFlt‐1 and PIGF, and receiver operating characteristic graphs were used to quantify the performance of each individual marker and their ratios in predicting normal versus pathological pregnancies affected by preeclampsia and/or FGR. Results There was a significant correlation between plasma PlGF and urinary PlGF ( r = 0.718, P < 0.001) in all groups. In the pathological groups, plasma sFlt‐1 and urinary sFlt‐1 as well as plasma sFlt‐1: PIGF ratio and urinary sFlt‐1: PlGF ratio were higher, but plasma PIGF and urinary PlGF were lower when compared to normal pregnancy. Plasma PIGF and plasma sFlt‐1: PlGF ratio was comparable in performance to urinary PlGF and urinary sFlt‐1: PIGF ratio for the diagnosis of preeclampsia and/or FGR. Conclusion Urinary PIGF can be used as an alternative to circulating biomarkers in preeclampsia and FGR. Plasma sFlt‐1, PlGF and sFlt‐1: PlGF ratio as well as urinary PIGF and sFlt‐1: PlGF ratio can be used to differentiate between normal pregnancy and pregnancies complicated by preeclampsia and FGR.