Redefining probability of preeclampsia in high risk women using PlGF
later in pregnancy
Abstract
Objective: To determine the effectiveness and gestational
age-specific cut-off of Placental growth factor ( PlGF) in the second
half of pregnancy for the prediction of adverse materno-fetal outcome
among high-risk women. Methods: This secondary analysis
explored associations between placental growth factor (PlGF) among women
at high risk of PE at 20-22, 28-30, and 34-36 weeks of gestation. Women
were divided into two groups based on PlGF levels cut-off derived after
applying area under the receiver operating curve. Results: Of
the 287 high risk women, 116(40.4%) had preeclampsia (PE). The cut off
of PlGF was 224pg/ml, 211pg/ml and 176 pg/ml at 20-22, 28-30 and 34-36
weeks respectively, nearly 30% of the high risk women had PlGF below
cut-off. The sensitivity and specificity of PE prediction using PlGF at
20-22 weeks was 81.0% and 72.2% respectively. For PlGF done at 28-30
weeks, the sensitivity and specificity of PE prediction till 32 weeks
were 91.7% and 78.5% respectively. For PlGF done at 34-36 weeks, the
sensitivity and specificity of PE prediction till 37 weeks was 95.8%
and 73.3%, respectively. The negative predictive value of the PlGF at
any gestation was nearly 90% or above for PE prediction till delivery.
The accuracy of the test was highest at 28-30 weeks and for prediction
before 37 weeks. Conclusion: The PlGF is a good marker to be
done at 28-30 weeks for prediction of PE especially early onset and its
adverse outcome; it can also be done at 34-36 weeks for preterm PE
prediction.