Hong, Jesrine and Crawford, Kylie and Cavanagh, Erika and Clifton, Vicki and Kumar, Sailesh (2024) Prediction of preterm birth in women with fetal growth restriction - Is the weekly change in sFlt-1/PlGF ratio or PlGF levels useful? Acta Obstetricia et Gynecologica Scandinavica, 103 (6). pp. 1112-1119. ISSN 0001-6349, DOI https://doi.org/10.1111/aogs.14831.
Full text not available from this repository.Abstract
Introduction: To assess the rate of change in soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PlGF) ratio and PlGF levels per week compared to a single sFlt-1/PlGF ratio or PlGF level to predict preterm birth for pregnancies complicated by fetal growth restriction. Material and methods: A prospective cohort study of pregnancies complicated by isolated fetal growth restriction. Maternal serum PlGF levels and the sFlt-1/PlGF ratio were measured at 4-weekly intervals from recruitment to delivery. We investigated the utility of PlGF levels, sFlt-1/PlGF ratio, change in PlGF levels per week or sFlt-1/PlGF ratio per week. Cox-proportional hazard models and Harrell's C concordance statistic were used to evaluate the effect of biomarkers on time to preterm birth. Results: The total study cohort was 158 pregnancies comprising 91 (57.6%) with fetal growth restriction and 67 (42.4%) with appropriate for gestational age controls. In the fetal growth restriction cohort, sFlt-1/PlGF ratio and PlGF levels significantly affected time to preterm birth (Harrell's C: 0.85-0.76). The rate of increase per week of the sFlt-1/PlGF ratio (hazard ratio HR] 3.91, 95% confidence interval CI]: 1.39-10.99, p = 0.01, Harrell's C: 0.74) was positively associated with preterm birth but change in PlGF levels per week was not (HR 0.65, 95% CI: 0.25-1.67, p = 0.37, Harrell's C: 0.68). Conclusions: Both a high sFlt-1/PlGF ratio and low PlGF levels are predictive of preterm birth in women with fetal growth restriction. Although the rate of increase of the sFlt-1/PlGF ratio predicts preterm birth, it is not superior to either a single elevated sFlt-1/PlGF ratio or low PlGF level.
| Item Type: | Article |
|---|---|
| Funders: | National Health & Medical Research Council (NHMRC) of Australia, University of Queensland, as part of the Wiley - The University of Queensland agreement via the Council of Australian University Librarians |
| Uncontrolled Keywords: | fetal growth restriction; placental dysfunction; placental growth factor; PlGF; pre-eclampsia; pregnancy; preterm birth; sFlt-1; sFlt-1/PlGF ratio; small for gestational age; soluble fms-like tyrosine kinase 1 |
| Subjects: | R Medicine > RG Gynecology and obstetrics |
| Divisions: | Faculty of Medicine > Obstetrics & Gynaecology Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 08 Jan 2025 07:06 |
| Last Modified: | 08 Jan 2025 07:06 |
| URI: | http://eprints.um.edu.my/id/eprint/47017 |
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