Back to Search
Start Over
Predicting delivery of a small-for-gestational-age infant and adverse perinatal outcome in women with suspected pre-eclampsia.
- Source :
-
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology [Ultrasound Obstet Gynecol] 2018 Mar; Vol. 51 (3), pp. 387-395. Date of Electronic Publication: 2018 Feb 07. - Publication Year :
- 2018
-
Abstract
- Objective: To evaluate the test performance of 47 biomarkers and ultrasound parameters for the prediction of delivery of a small-for-gestational-age (SGA) infant and adverse perinatal outcome in women presenting with suspected pre-eclampsia.<br />Methods: This was a prospective, multicenter observational study in which 47 biomarkers and ultrasound parameters were measured in 397 women with a singleton pregnancy presenting with suspected preterm pre-eclampsia between 20 + 0 and 36 + 6 weeks' gestation, with the objective of evaluating them as predictors of subsequent delivery of a SGA infant and adverse perinatal outcome. Women with confirmed pre-eclampsia at enrollment were excluded. Factor analysis and stepwise logistic regression were performed in two prespecified groups stratified according to gestational age at enrollment. The primary outcome was delivery of a SGA infant with a birth weight < 3 <superscript>rd</superscript> customized centile (SGA-3), and secondary outcomes were a SGA infant with a birth weight < 10 <superscript>th</superscript> customized centile and adverse perinatal outcome.<br />Results: In 274 women presenting at 20 + 0 to 34 + 6 weeks' gestation, 96 (35%) delivered a SGA-3 infant. For prediction of SGA-3, low maternal placental growth factor (PlGF) concentration had a sensitivity of 93% (95% CI, 84-98%) and negative predictive value (NPV) of 90% (95% CI, 76-97%) compared with a sensitivity of 71% (95% CI, 58-82%) and a NPV of 79% (95% CI, 68-87%) for ultrasound parameters (estimated fetal weight or abdominal circumference < 10 <superscript>th</superscript> centile). No individual biomarker evaluated had a better performance than did PlGF, and marker combinations made only small improvements to the test performance. Similar results were found in 123 women presenting between 35 + 0 and 36 + 6 weeks' gestation.<br />Conclusion: In women presenting with suspected preterm pre-eclampsia, measurement of PlGF offers a useful adjunct for identifying those at high risk of delivering a SGA infant, allowing appropriate surveillance and timely intervention. © 2017 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.<br /> (© 2017 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.)
- Subjects :
- Adult
Birth Weight
Female
Fetal Growth Retardation physiopathology
Fetal Weight
Humans
Infant, Newborn
Infant, Small for Gestational Age
Predictive Value of Tests
Pregnancy
Pregnancy Outcome
Pregnancy Trimester, Second
Pregnancy Trimester, Third
Prospective Studies
Fetal Growth Retardation blood
Fetal Growth Retardation diagnostic imaging
Pre-Eclampsia blood
Pre-Eclampsia physiopathology
Pregnancy Proteins blood
Ultrasonography, Prenatal
Subjects
Details
- Language :
- English
- ISSN :
- 1469-0705
- Volume :
- 51
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
- Publication Type :
- Academic Journal
- Accession number :
- 28401605
- Full Text :
- https://doi.org/10.1002/uog.17490