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Prediction of birth weight small for gestational age with and without preeclampsia by angiogenic markers: an Odense Child Cohort Study

Authors

  • L.H. Bækgaard Thorsen
  • L. Bjørkholt Andersen
  • A. Birukov
  • S. Lykkedegn
  • R. Dechend
  • J. Stener Jørgensen
  • H. Thybo Christesen

Journal

  • Journal of Maternal-Fetal & Neonatal Medicine

Citation

  • J Matern Fetal Neonatal Med 33 (8): 1377-1384

Abstract

  • OBJECTIVE: To investigate the predictive performance of placental growth factor (PlGF) and soluble FMS-like kinase 1 (sFlt-1) on birth weight and small for gestational age (SGA), in a large, population-based cohort. METHODS: Women enrolled in the population-based, prospective Odense Child Cohort Study with early (GA < 20 weeks) and/or late (≥ 20 weeks) pregnancy blood samples (n = 1937) were included. The association between log-transformed values of the biomarkers and birth weight Z-score was studied using multivariate regression models. The prediction of SGA overall, and in women developing preeclampsia, by biomarkers was evaluated using receiver operating characteristic analyses. RESULTS: No substantial associations between early pregnancy biomarkers and SGA were seen. PlGF measured in late pregnancy demonstrated the strongest association with birth weight Z-score (adjusted β-coefficient = 0.43 [95%CI = 0.35; 0.50]). The area under curve (AUC) for predicting SGA was higher for sFlt-1/PlGF compared to sFlt-1 (0.74 versus 0.63, p = 0.006) and reached excellent prediction for SGA after preeclampsia (AUC 0.94). Optimal sFlt-1/PlGF ratio cut-offs had higher negative predictive value (NPV) and positive predictive value (PPV) for SGA (cut-off > 5.0; NPV = 99.1%, PPV = 5.4%) compared to each marker individually. CONCLUSION: The sFlt-1/PlGF ratio is a potential predictor of SGA in population-based screening, particularly when preeclampsia is also present. What is new: The sFlt-1/PlGF ratio is a potential predictor of SGA on a population level with higher predictive values compared to sFlt-1 or PlGF, but with low positive predictive value when used alone. WHAT IS NEW: The sFlt-1/PlGF ratio is a potential predictor of SGA on a population level with higher predictive values compared to sFlt-1 or PlGF, but with low positive predictive value when used alone.


DOI

doi:10.1080/14767058.2018.1519536