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

被引：36

作者：

Griffin, M. ^{[1
]}

Seed, P. T. ^{[1
]}

Duckworth, S. ^{[1
]}

North, R. ^{[1
]}

Myers, J. ^{[2
]}

Mackillop, L. ^{[3
]}

Simpson, N. ^{[4
]}

Waugh, J. ^{[5
]}

Anumba, D. ^{[6
]}

Kenny, L. C. ^{[7
]}

Redman, C. W. G. ^{[8
]}

Shennan, A. H. ^{[1
]}

Chappell, L. C. ^{[1
]}

机构：

[1] Kings Coll London, Womens Hlth Acad Ctr, London SE1 7EH, England

[2] Univ Manchester, Maternal & Fetal Hlth Res Ctr, Manchester, Lancs, England

[3] Oxford Univ Hosp NHS Trust, Oxford, England

[4] Univ Leeds, Fac Hlth, Div Womens & Childrens Hlth, Leeds, W Yorkshire, England

[5] Newcastle Tyne Hosp NHS Fdn Trust, Newcastle, NSW, Australia

[6] Univ Sheffield, Acad Unit Reprod & Dev Med, Sheffield, S Yorkshire, England

[7] Univ Coll Cork, INFANT Irish Ctr Fetal & Neonatal Translat Res, Cork, Ireland

[8] Univ Oxford, Nuffield Dept Obstet & Gynaecol, Oxford, England

来源：

ULTRASOUND IN OBSTETRICS & GYNECOLOGY | 2018年 / 51卷 / 03期

基金：

爱尔兰科学基金会; 美国国家卫生研究院;

关键词：

growth restriction; placental growth factor; pre-eclampsia; small-for-gestational-age; PLACENTAL GROWTH-FACTOR; BIRTH-WEIGHT; DIAGNOSTIC-ACCURACY; ANGIOGENIC FACTORS; RESTRICTION; FETAL; RISK; PREGNANCIES; STILLBIRTH; SERUM;

D O I：

10.1002/uog.17490

中图分类号：

O42 [声学];

学科分类号：

070206 ; 082403 ;

摘要：

Objective 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. Methods 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 < 3rd customized centile (SGA-3), and secondary outcomes were a SGA infant with a birth weight < 10th customized centile and adverse perinatal outcome. Results 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 < 10th 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. Conclusion 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. (c) 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.

引用

页码：387 / 395

页数：9

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