PlGF in a clinical setting of pregnancies at risk of preeclampsia and/or intrauterine growth restriction

Abstract

Placental growth factor (PlGF) is an angiogenic molecule produced by the placenta and implicated in the pathogenesis of preeclampsia (PE) and intrauterine growth restriction (IUGR). We have evaluated utility and applicability of the PlGF test in a clinical setting of pregnancies at risk of PE or complicated by IUGR in order to assess its relationship with pregnancy outcomes. Seventy-three pregnancies were enrolled between 19 and 35 weeks: 57 pregnancies at risk of PE and 16 at diagnosis of IUGR. Maternal circulating PlGF levels were measured by the Triage PlGF test (Alere, San Diego, CA). Pregnancy outcomes were evaluated in relation to three categories of plasma PlGF levels: very low (<12 pg/ml), low (12–100 pg/ml) and normal (≥100 pg/ml). Uterine artery Doppler velocimetry (UADV) pulsatility index (PI) was measured in the same patients on the day of maternal sampling. Pregnancies at risk with very low plasma PlGF levels had significantly lower gestational age at delivery than patients with low or normal PlGF. The rate of emergency C-section was significantly higher in the group with PlGF <12 pg/ml. IUGR pregnancies with very low and low PlGF delivered earlier than patients with normal PlGF. All IUGR with very low and low PlGF had UADV PI > 95th percentile. Our data indicate that PlGF may provide useful information to identify fetuses requiring increased surveillance and possibly urgent delivery in pregnancies at risk of adverse outcomes. Furthermore, in IUGR, PlGF can predict adverse pregnancy outcomes that may be secondary to placental insufficiency.

• IUGR
• preeclampsia
• pregnancy outcomes
• uterine artery Doppler velocimetry

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Results of this study were partially presented at the Society for Gynecologic Investigations (SGI) 61st Annual Scientific Meeting (26–29 March 2014, Florence, Italy).

This work has been financially supported by grants from Fondazione Giorgio Pardi, by ASM (Associazione Italiana per lo Studio delle Malformazioni) and by Grants of the Italian Ministry of University and Research PRIN 2010–2011 prot. 20102 chst5_005 “Parto pre-termine: markers molecolari, biochimici e biofisici dell' unità feto-placentare” to I.C.