A low angiogenic index-1 (placental growth factor/soluble vascular endothelial growth factor receptor-1 ratio) at 24-28 weeks of gestation is a biomarker to identify the patient at risk for subsequent fetal death Academic Article uri icon

abstract

  • Objective We sought to determine if maternal plasma concentrations of angiogenic and antiangiogenic factors measured at 24-28 weeks of gestation can predict subsequent fetal death. Study Design A case-cohort study was designed to include 1000 randomly selected subjects and all remaining fetal deaths (cases) from a cohort of 4006 women with a singleton pregnancy, enrolled at 6-22 weeks of gestation, in a pregnancy biomarker cohort study. The placentas of all fetal deaths were histologically examined by pathologists who used a standardized protocol and were blinded to patient outcomes. Placental growth factor, soluble endoglin, and soluble vascular endothelial growth factor receptor-1 concentrations were measured by enzyme-linked immunosorbent assays. Quantiles of the analyte concentrations (or concentration ratios) were estimated as a function of gestational age among women who delivered live neonates but did not develop preeclampsia or deliver small-for-gestational-age newborns. A positive test was defined as analyte concentrations (or ratios) 90th and 97.5th centiles (soluble vascular endothelial growth factor receptor-1 and soluble endoglin). Inverse probability weighting was used to reflect the parent cohort when estimating the relative risk. Results There were 11 fetal deaths and 829 controls with samples available for analysis between 24-28 weeks of gestation. Three fetal deaths occurred 24 weeks (14.6; 95% confidence interval, 7.7–27.7) and a relative risk of 29.1 (95% confidence interval, 8.8–97.1), followed by soluble endoglin >97.5th centile and placental growth factor/soluble endoglin Conclusion (1) A maternal plasma angiogenic index-1 value

publication date

  • January 1, 2017