Plasma concentrations of angiogenic/anti-angiogenic factors have prognostic value in women presenting with suspected preeclampsia to the obstetrical triage area: a prospective study
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作者:
Chaiworapongsa, Tinnakorn
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NICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USA
Wayne State Univ, Dept Obstet Gynecol, Detroit, MI 48201 USANICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USA
Chaiworapongsa, Tinnakorn
[1
,2
]
Romero, Roberto
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NICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USANICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USA
Romero, Roberto
[1
]
Korzeniewski, Steven J.
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NICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USA
Wayne State Univ, Dept Obstet Gynecol, Detroit, MI 48201 USANICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USA
Korzeniewski, Steven J.
[1
,2
]
Cortez, Josef M.
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机构:
Wayne State Univ, Dept Pediat, Detroit, MI 48201 USANICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USA
Cortez, Josef M.
[3
]
Pappas, Athina
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Wayne State Univ, Dept Pediat, Detroit, MI 48201 USANICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USA
Pappas, Athina
[3
]
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Tarca, Adi L.
[1
,4
]
Chaemsaithong, Piya
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机构:
NICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USA
Wayne State Univ, Dept Obstet Gynecol, Detroit, MI 48201 USANICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USA
Chaemsaithong, Piya
[1
,2
]
Dong, Zhong
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NICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USANICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USA
Dong, Zhong
[1
]
Yeo, Lami
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机构:
NICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USA
Wayne State Univ, Dept Obstet Gynecol, Detroit, MI 48201 USANICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USA
Yeo, Lami
[1
,2
]
Hassan, Sonia S.
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机构:
NICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USA
Wayne State Univ, Dept Obstet Gynecol, Detroit, MI 48201 USANICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USA
Hassan, Sonia S.
[1
,2
]
机构:
[1] NICHD, Perinatol Res Branch, NIH, DHHS, Detroit, MI USA
[2] Wayne State Univ, Dept Obstet Gynecol, Detroit, MI 48201 USA
[3] Wayne State Univ, Dept Pediat, Detroit, MI 48201 USA
[4] Wayne State Univ, Dept Comp Sci, Detroit, MI 48201 USA
Objective: To prospectively determine the prognostic value of maternal plasma concentrations of placental growth factor (PlGF), soluble endoglin (sEng) and soluble vascular endothelial growth factor receptors-1 and -2 (sVEGFR-1 and -2) in identifying patients with suspected preeclampsia (PE), who require preterm delivery (PTD) or develop adverse outcomes. Study design: This prospective cohort study included 85 consecutive patients who presented to the obstetrical triage area at 20-36 weeks with a diagnosis of "rule out PE." Patients were classified as: 1) those who remained stable until term (n = 37); and 2) those who developed severe PE and required PTD (n = 48). Plasma concentrations of PlGF, sEng and sVEGFR-1 and -2 were determined by ELISA. Results: Patients with PlGF/sVEGFR-1 <= 0.05 multiples of the median (MoM) or PlGF/sEng <= 0.07 MoM were more likely to deliver preterm due to PE [adjusted odd ratio (aOR) 7.4 and 8.8], and to develop maternal (aOR 3.7 and 2.4) or neonatal complications (aOR 10.0 and 10.1). Among patients who presented <34 weeks of gestation, PlGF/sVEGFR-1 <= 0.035 MoM or PlGF/sEng <= 0.05 MoM had a sensitivity of 89% (16/18), specificity of 96% (24/25) and likelihood ratio for a positive test of 22 to identify patients who delivered within 2 weeks. The addition of the PlGF/sVEGFR-1 ratio to standard clinical tests improved the sensitivity at a fixed false-positive rate of 3% (p = 0.004) for the identification of patients who were delivered due to PE within 2 weeks. Among patients who had a plasma concentration of PlGF/sVEGFR-1 ratio <= 0.035 MoM, 0.036-0.34 MoM and >= 0.35 MoM, the rates of PTD <34 weeks were 94%, 27% and 7%, respectively. Conclusions: The determination of angiogenic/anti-angiogenic factors has prognostic value in patients presenting to the obstetrical triage area with suspected PE for the identification of those requiring preterm delivery and at risk for adverse maternal/neonatal outcomes.
机构:
Univ Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USAUniv Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USA
Parrish, Marc R.
Laye, M. Ryan
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Univ Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USAUniv Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USA
Laye, M. Ryan
Wood, Tommy
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Univ Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USAUniv Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USA
Wood, Tommy
Keiser, Sharon D.
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Univ Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USAUniv Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USA
Keiser, Sharon D.
Owens, Michelle Y.
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Univ Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USAUniv Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USA
Owens, Michelle Y.
May, Warren L.
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Univ Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USAUniv Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USA
May, Warren L.
Martin, James N., Jr.
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Univ Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USAUniv Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USA
机构:
Univ Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USAUniv Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USA
Parrish, Marc R.
Laye, M. Ryan
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h-index: 0
机构:
Univ Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USAUniv Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USA
Laye, M. Ryan
Wood, Tommy
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h-index: 0
机构:
Univ Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USAUniv Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USA
Wood, Tommy
Keiser, Sharon D.
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h-index: 0
机构:
Univ Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USAUniv Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USA
Keiser, Sharon D.
Owens, Michelle Y.
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h-index: 0
机构:
Univ Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USAUniv Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USA
Owens, Michelle Y.
May, Warren L.
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h-index: 0
机构:
Univ Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USAUniv Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USA
May, Warren L.
Martin, James N., Jr.
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h-index: 0
机构:
Univ Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USAUniv Mississippi, Med Ctr, Dept Obstet & Gynecol, Winfred L Wiser Hosp Women & Infants, Jackson, MS 39216 USA