scholarly journals Ruling out preeclampsia in the next 4 weeks using an sFlt-1/PlGF ratio ≤38: secondary analysis of the INSPIRE trial

2021 ◽  
Author(s):  
Ana Sofia Cerdeira ◽  
Joe O’sullivan ◽  
Eric O. Ohuma ◽  
Tim James ◽  
Aris T. Papageorghiou ◽  
...  
Keyword(s):  
Secondary Analysis ◽  
Plgf Ratio

scholarly journals Maternal Serum Inhibin-A Augments the Value of Maternal Serum PlGF and of sFlt-1/PlGF Ratio in the Prediction of Preeclampsia and/or FGR Near Delivery—A Secondary Analysis

2021 ◽  
Vol 2 (1) ◽  
pp. 35-49
Author(s):  
Adi Sharabi-Nov ◽  
Tanja Premru Sršen ◽  
Kristina Kumer ◽  
Vesna Fabjan Vodušek ◽  
Teja Fabjan ◽  
...  
Keyword(s):  
Growth Factor ◽  
Transforming Growth Factor ◽  
Predictive Accuracy ◽  
Secondary Analysis ◽  
Serum Levels ◽  
Maternal Serum ◽  
Added Value ◽  
Operating Characteristics ◽  
Inhibin A ◽  
Plgf Ratio

Objective: We previously provided evidence to confirm that maternal serum levels of soluble Fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and their ratio are useful tools to direct the management of preeclampsia (PE), fetal growth restriction (FGR), and PE+FGR near delivery. In this secondary analysis, we further examine the potential additive value of maternal serum Inhibin-A, which is a hormone marker of the transforming growth factor family, to the accuracy provided by maternal serum PlGF and sFlt-1. Methods: We conducted a secondary analysis where we extracted the data of a cohort of 125 pregnant women enrolled near delivery at the clinics of the University Medical Center of Ljubljana, Slovenia. The dataset included 31 cases of PE, 16 of FGR, 42 of PE+FGR, 15 preterm delivery (PTD), and 21 unaffected controls with delivery of a healthy baby at term. Cases delivered before 34 weeks’ gestation included 10 of PE, 12 of FGR, 28 of PE+FGR, and 6 of PTD. In addition to the recorded demographic characteristics and medical history and the maternal serum levels of PlGF and sFlt-1/PlGF ratio, which were previously published, we evaluated the added value of maternal serum Inhibin-A. The predictive accuracy of each biomarker, their ratios, and combinations were estimated from areas under the curve (AUC) of receiver operating characteristics (ROC) curves, Box and Whisker plots, and by multiple regression. We estimated accuracy by the continuous marker model and a cutoff model. Results: In this study, we combined Inhibin-A with PlGF or with the sFlt-1/PlGF ratio and showed a 10–20% increase in AUCs and 15–45% increase in the detection rate, at 10% false positive rate, of PE, and a lower, but significant, increase for PE+FGR and FGR in all cases but not for FGR in early cases delivered < 34 weeks. The use of a cutoff model was adequate, although a bit higher accuracy was obtained from the continuous model. The highest correlation was found for PlGF with all three complications. Conclusion: In this secondary analysis, we have found that maternal serum Inhibin-A improves the accuracy of predicting PE and PE+FGR provided by maternal serum angiogenic markers alone, bringing the results to a diagnostic level; thus, it could be considered for directing clinical management. Inhibin-A had smaller or no added value for the accuracy of predicting FGR alone, mainly of early cases delivered <34 weeks.

scholarly journals PAPP‐A2 and Inhibin A as Novel Predictors for Pregnancy Complications in Women With Suspected or Confirmed Preeclampsia

2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Rugina I. Neuman ◽  
Maaike M. Alblas van der Meer ◽  
Daan Nieboer ◽  
Langeza Saleh ◽  
Koen Verdonk ◽  
...  
Keyword(s):  
Gestational Age ◽  
Pregnancy Complications ◽  
Secondary Analysis ◽  
Maternal Complications ◽  
Discriminative Ability ◽  
Inhibin A ◽  
Multicenter Observational Study ◽  
Novel Biomarkers ◽  
Angiogenic Biomarkers ◽  
Plgf Ratio

Background We aimed to evaluate the value of inhibin A and PAPP‐A2 (pregnancy‐associated plasma protein‐A2) as novel biomarkers in the prediction of preeclampsia‐related complications and how they compare with angiogenic biomarkers. Methods and Results Making use of a secondary analysis of a prospective, multicenter, observational study, intended to evaluate the usefulness of sFlt‐1 (soluble Fms‐like tyrosine kinase‐1)/PlGF (placental growth factor) ratio, we measured inhibin A and PAPP‐A2 levels in 524 women with suspected/confirmed preeclampsia. Women had a median gestational age of 35 weeks (range, 20–41 weeks) while preeclampsia occurred in 170 (32%) women. Levels of inhibin A and PAPP‐A2 were significantly increased in women with preeclampsia and in maternal perfusate of preeclamptic placentas. Inhibin A and PAPP‐A2 (C‐index = 0.73 and 0.75) significantly improved the prediction of maternal complications when added on top of the traditional criteria; gestational age, parity, proteinuria, and diastolic blood pressure (C‐index = 0.60). PAPP‐A2 was able to improve the C‐index from 0.75 to 0.77 when added on top of the sFlt‐1/PlGF ratio for the prediction of maternal complications. To discriminate fetal/neonatal complications on top of traditional criteria, inhibin A and PAPP‐A2 showed additive value (C‐index = 0.79 to 0.80 and 0.82, respectively) but their discriminative ability remained inferior to that of sFlt‐1/PlGF ratio or PlGF. Interestingly, the PAPP‐A2/PlGF ratio alone showed remarkable value to predict pregnancy complications, being superior to sFlt‐1/PlGF ratio in the case of maternal complications. Conclusions Inhibin A and PAPP‐A2 show significant potential to predict preeclampsia‐related pregnancy complications and might prove beneficial on top of the angiogenic markers.

Morning bright light therapy: a helpful tool for reducing comorbid symptoms of affective and behavioral dysregulation in juvenile depressed inpatients? A pilot trial

2017 ◽  
Vol 45 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Sarah Bogen ◽  
Tanja Legenbauer ◽  
Stephanie Gest ◽  
Martin Holtmann
Keyword(s):  
Pilot Trial ◽  
Secondary Analysis ◽  
Bright Light ◽  
Light Therapy ◽  
Bright Light Therapy ◽  
Circadian Phase ◽  
Behavioral Dysregulation ◽  
Sleep Parameters ◽  
Circadian Effect ◽  
Dysregulation Profile

Abstract. Objective: In recent years, bright light therapy (BLT) has been used to treat depression and to stabilize circadian rhythms. In this study we evaluated whether it is also helpful for comorbid symptoms of affective and behavioral dysregulation in depressive inpatients. Method: This article reports a secondary analysis comparing two subgroups of depressive participants with comorbid affective and behavioral dysregulation, captured with the dysregulation-profile of the Strengths and Difficulties Questionnaire (SDQ-DP; n = 16 vs. n = 11). Participants were randomly allocated to active BLT (10,000 lux) or control BLT (approx. 100 lux), and received 45 minutes of BLT for 2 weeks. SDQ-DP scores, sleep parameters, and circadian preference were assessed at baseline, after the intervention, and 3 weeks later. Results: No direct effects on SDQ-DP scores were observed. Sleep improved in both conditions. Only in the active BLT condition was a circadian phase advance found. Correlation and regression analyses indicated an indirect, circadian effect for improved SDQ-DP scores. Conclusions: The data of this pilot trial should be considered preliminary and merely descriptive. Further research is warranted.


Die sFlt-1/PlGF Ratio – neue Serummarker für die Prognose und Prädiktion der Präeklampsie – „from bench to bedside“ in 7 Jahren

2011 ◽  
Vol 71 (11) ◽  
Author(s):  
S Verlohren ◽  
J Pape ◽  
T Engels ◽  
JW Dudenhausen ◽  
E Beinder ◽  
...  
Keyword(s):  
Plgf Ratio

Outcome of pregnancies with very elevated levels of sFlt-1/PlGF ratio

2017 ◽  
Vol 77 (04) ◽  
pp. 379-395
Author(s):  
D Wertaschnigg ◽  
C Fazelnia ◽  
E Doelzmueller ◽  
C Kölblinger ◽  
C Wohlmuth
Keyword(s):  
Plgf Ratio

‘Sometimes you need to think outside their boxes’: An Examination of the Voice of Black Minority Ethnic Women in Post-Devolution Scotland

2014 ◽  
Vol 23 (4) ◽  
pp. 419-444
Author(s):  
Josephine Casserly
Keyword(s):  
Qualitative Interviews ◽  
Secondary Analysis ◽  
Third Sector ◽  
Political Life ◽  
Primary Data ◽  
Political Processes ◽  
Focus Group Data ◽  
Feminist Theories ◽  
The Voice ◽  
Minority Ethnic

This article explores the voice of black minority ethnic (BME) women in devolved Scotland. Particular attention is given to examining multicultural policies and devolved political processes and how these impact on the position of BME women in the political life of Scotland. The study is based on secondary analysis of existing survey and focus group data, and primary data drawn from qualitative interviews conducted with a sample of respondents from political and non-governmental organisations. Drawing on feminist theories of multiculturalism, culture is perceived as dynamic and contested and the research depicts BME women as agents engaged in shaping Scotland and their own cultures. The findings show that devolution has created a political opportunity structure more favourable to the voices of BME women. However, this voice remains quiet and is limited by barriers within and outside of BME communities. The research also highlights the role of third sector organisations in enabling the voice of BME women. The author concludes by arguing that successive devolved governments’ promotion of multiculturalism in Scotland has benefited BME women but with important limitations.

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