Hong, Jesrine and Crawford, Kylie and Daly, Matthew and Clifton, Vicki and Costa, Fabricio da Silva and Perkins, Anthony V. and Matsika, Admire and Lourie, Rohan and Kumar, Sailesh (2024) Utility of placental biomarkers and fetoplacental Dopplers in predicting likely placental pathology in early and late fetal growth restriction - A prospective study. Placenta, 156. pp. 20-29. ISSN 0143-4004, DOI 0.1016/j.placenta.2024.08.016.
Full text not available from this repository.Abstract
Introduction: The aim of this study was to evaluate the association between placental abnormalities, placental biomarkers, and fetoplacental Dopplers in a cohort of pregnancies complicated by fetal growth restriction (FGR). We also ascertained the risk of perinatal mortality, severe neurological morbidity, and severe non-neurological morbidity by type of placental abnormality. Methods: This was a prospective cohort study. Multivariable logistic regression was used to evaluate the effect of early vs. late FGR, placental biomarkers and fetoplacental Dopplers on Maternal Vascular Malperfusion (MVM) which was the commonest placental abnormality identified. Results: There were 161 (53.5 %) early FGR and 140 (46.5 %) late FGR cases. MVM abnormalities were present in 154 (51.2 %), VUE in 45(14.6 %), FVM in 16(5.3 %), DVM in 14(4.7 %) and CHI in 4(1.3 %) cases. The odds of MVM were higher in early compared to late FGR cohort (OR 1.89, 95%CI 1.14, 3.14, p = 0.01). Low maternal PlGF levels 6100 ng/L (OR 2.34, 95%CI 1.27,4.31, p = 0.01), high sFlt-1 level (OR 2.13, 95%CI 1.35, 3.36, p = 0.001) or elevated sFlt-1/PlGF ratio (OR 3.48, 95%CI 1.36, 8.91, p = 0.01) were all associated with MVM. Increased UA PI > 95th centile (OR 2.91, 95%CI 1.71, 4.95, p=60.001) and mean UtA PI z-score (OR 1.74, 95% CI 1.15, 2.64, p = 0.01) were associated with higher odds of MVM. Rates of severe non-neurological morbidity were highest in the MVM, FVM, and CHI cohorts (44.8 %, 50 %, and 50 % respectively). Conclusion: MVM was the commonest placental abnormality in FGR, particularly in early-onset disease. Low maternal PlGF levels, high sFlt-1 levels, elevated sFlt-1/PlGF ratio, and abnormal fetoplacental Dopplers were also significantly associated with MVM. MVM, FVM, and CHI abnormalities were associated with lower median birthweight, higher rates of preterm birth, operative birth for non-reassuring fetal status, and severe neonatal non-neurological morbidity.
| Item Type: | Article |
|---|---|
| Funders: | National Health & Medical Research Council (NHMRC) of Australia, Mater Foundation |
| Uncontrolled Keywords: | Pregnancy; Placental pathology; Fetal growth restriction; Placental dysfunction; Maternal vascular malperfusion; Placental growth factor; Soluble-fms like tyrosine kinase-1 |
| Subjects: | R Medicine > RG Gynecology and obstetrics |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 13 Oct 2025 03:58 |
| Last Modified: | 13 Oct 2025 03:58 |
| URI: | http://eprints.um.edu.my/id/eprint/46528 |
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