The role of the PLGF in the prediction of the outcome in pregnancies with a small for gestational age fetus

Athena P Souka; Panagiotis Antsaklis; Konstantinos Tassias; Maria Anna Chatziioannou; Maria Papamihail; George Daskalakis

doi:10.1007/s00404-023-07214-2

The role of the PLGF in the prediction of the outcome in pregnancies with a small for gestational age fetus

Arch Gynecol Obstet. 2023 Oct 14. doi: 10.1007/s00404-023-07214-2. Online ahead of print.

Authors

Athena P Souka¹, Panagiotis Antsaklis², Konstantinos Tassias², Maria Anna Chatziioannou², Maria Papamihail², George Daskalakis²

Affiliations

¹ Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens-Faculty of Medicine, 41, D. Soutsou Str, 11521, Athens, Greece. athena.souka@gmail.com.
² Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens-Faculty of Medicine, 41, D. Soutsou Str, 11521, Athens, Greece.

PMID: 37837546
DOI: 10.1007/s00404-023-07214-2

Abstract

Purpose: To explore the value of measuring maternal serum PLGF in the prediction of the outcome of small for gestational age fetuses (SGA).

Methods: Singleton pregnancies referred with suspicion of SGA in the third trimester were included if they had: no indication for nor signs of imminent delivery, fetal abdominal circumference (AC) at or below the 10th centile and/or estimated fetal weight (EFW) at or below the 10th centile and/or umbilical artery pulsatility index (Umb-PI) at or above the 90th centile for gestation. Women with pre-eclampsia at presentation were excluded. Maternal blood was drawn at the first (index) visit and analyzed retrospectively.

Results: Fifty-one fetuses were examined. Multiple regression analysis showed that family history of microsomia, index EFW and PLGF were significant predictors of the birthweight centile; index femur length centile and PLGF were significant predictors of pre-eclampsia; PLGF and index systolic blood pressure were significant predictors of iatrogenic preterm delivery < 37 weeks, whereas PLGF and index EFW were significant predictors of birthweight ≤ 5th centile and admission to the neonatal intensive care unit. For all outcomes, the addition of maternal-fetal parameters did not improve the prediction compared to PLGF alone. Using a cutoff of 0.3 MoM for PLGF would identify 94.1% of the pregnancies with iatrogenic preterm delivery and/or intra-uterine death and all of the cases that developed pre-eclampsia, for a screen positive rate of 54.9%. Women with PLGF ≤ 0.3 MoM had a poor fetal/maternal outcome (iatrogenic preterm delivery, pre-eclampsia, intra-uterine death) in 61.5% of cases.

Conclusion: In pregnancies complicated by SGA, PLGF identifies a very high-risk group that may benefit from intense surveillance.

Keywords: Growth restrictio; PLGF; Pre-eclampsia; SGA.