Predicting delivery of a small-for-gestational-age infant and adverse perinatal outcome in women with suspected pre-eclampsia

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Griffin, M, Seed, PT, Duckworth, S, North, R, Myers, J, Mackillop, L, Simpson, N, Waugh, J, Anumba, D, Kenny, LC ORCID: 0000-0002-9011-759X et al (show 3 more authors) , Redman, CWG, Shennan, AH and Chappell, LC (2018) Predicting delivery of a small-for-gestational-age infant and adverse perinatal outcome in women with suspected pre-eclampsia. ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 51 (3). pp. 387-395.

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Abstract

<h4>Objective</h4>To evaluate the test performance of 47 biomarkers and ultrasound parameters for the prediction of delivery of a small-for-gestational-age (SGA) infant and adverse perinatal outcome in women presenting with suspected pre-eclampsia.<h4>Methods</h4>This was a prospective, multicenter observational study in which 47 biomarkers and ultrasound parameters were measured in 397 women with a singleton pregnancy presenting with suspected preterm pre-eclampsia between 20 + 0 and 36 + 6 weeks' gestation, with the objective of evaluating them as predictors of subsequent delivery of a SGA infant and adverse perinatal outcome. Women with confirmed pre-eclampsia at enrollment were excluded. Factor analysis and stepwise logistic regression were performed in two prespecified groups stratified according to gestational age at enrollment. The primary outcome was delivery of a SGA infant with a birth weight < 3^rd customized centile (SGA-3), and secondary outcomes were a SGA infant with a birth weight < 10^th customized centile and adverse perinatal outcome.<h4>Results</h4>In 274 women presenting at 20 + 0 to 34 + 6 weeks' gestation, 96 (35%) delivered a SGA-3 infant. For prediction of SGA-3, low maternal placental growth factor (PlGF) concentration had a sensitivity of 93% (95% CI, 84-98%) and negative predictive value (NPV) of 90% (95% CI, 76-97%) compared with a sensitivity of 71% (95% CI, 58-82%) and a NPV of 79% (95% CI, 68-87%) for ultrasound parameters (estimated fetal weight or abdominal circumference < 10^th centile). No individual biomarker evaluated had a better performance than did PlGF, and marker combinations made only small improvements to the test performance. Similar results were found in 123 women presenting between 35 + 0 and 36 + 6 weeks' gestation.<h4>Conclusion</h4>In women presenting with suspected preterm pre-eclampsia, measurement of PlGF offers a useful adjunct for identifying those at high risk of delivering a SGA infant, allowing appropriate surveillance and timely intervention. © 2017 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.

Item Type:	Article
Uncontrolled Keywords:	growth restriction, placental growth factor, pre-eclampsia, small-for-gestational-age
Depositing User:	Symplectic Admin
Date Deposited:	16 Aug 2018 15:30
Last Modified:	19 Jan 2023 01:28
DOI:	10.1002/uog.17490
Open Access URL:	https://doi.org/10.1002/uog.17490
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3025105