First trimester screening of serum soluble fms-like tyrosine kinase-1 and placental growth factor predicting hypertensive disorders of pregnancy

Background: Soluble FMS-like Tyrosine Kinase 1 (sFlt-1) and placental growth factor (PlGF) have been reported to be highly predictive several weeks before the onset of preeclampsia. Objective: To investigate longitudinal changes of serum levels sFlt-1 and PlGF in pregnant women at high risk for the development of preeclampsia and to reveal an impact of aspirin on maternal serum concentrations of sFlt-1 and PlGF. Methods: This was a prospective longitudinal study in 394 women with various risk factors for the development of preeclampsia (chronic hypertension, antiphospholipid syndrome/APS or systemic lupus erythematosus/SLE, thrombophilia, women with a history of preeclampsia, pathologic first trimester screening for preeclampsia) and 68 healthy women. Serum levels of sFlt-1 and PlGF were measured prospectively at 4-week intervals (from gestational weeks 12 until postpartum). Results: The sFlt-1/PlGF ratio was significantly higher in women with an adverse obstetric outcome compared to women with a normal pregnancy, starting between 20 and 24 weeks of gestation. There was no effect of aspirin on sFlt-1/PlGF ratio in women with chronic hypertension, APS/SLE, thrombophilia and controls. The use of aspirin showed a trend towards an improvement of the sFlt-1/PlGF ratio in women with preeclampsia in a previous pregnancy and a significant effect on the sFlt-1/PlGF ratio in women with a pathologic first trimester screening for preeclampsia. Conclusions: Our findings reveal an impact of aspirin on sFlt-1/PlGF ratio in women with a pathologic first trimester screening for preeclampsia, strongly supporting its prophylactic use.

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Maternal serum placental growth factor and α -fetoprotein testing in first trimester screening for Down syndrome

Prenatal Diagnosis ◽

10.1002/pd.4087 ◽

2013 ◽

Vol 33 (5) ◽

pp. 457-461 ◽

Cited By ~ 19

Author(s):

Kim Donalson ◽

Steve Turner ◽

Lesley Morrison ◽

Päivi Liitti ◽

Christel Nilsson ◽

...

Keyword(s):

Down Syndrome ◽

Growth Factor ◽

First Trimester ◽

Maternal Serum ◽

Placental Growth Factor ◽

First Trimester Screening ◽

Trimester Screening

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Adverse Pregnancy Outcomes among Women with Low Placental Growth Factor and/or PAPP-A at the Enhanced First Trimester Screening

Journal of Obstetrics and Gynaecology Canada ◽

10.1016/j.jogc.2018.03.082 ◽

2018 ◽

Vol 40 (6) ◽

pp. 844

Author(s):

Elad Mei-Dan ◽

Kainat Amir ◽

Wendy Meschino ◽

Nir Melamed ◽

Jon Barrett ◽

...

Keyword(s):

Growth Factor ◽

Pregnancy Outcomes ◽

First Trimester ◽

Placental Growth Factor ◽

Adverse Pregnancy Outcomes ◽

First Trimester Screening ◽

Trimester Screening ◽

Adverse Pregnancy

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First Trimester Screening for Fetal Aneuploidies Using Placental Growth Factor: The Great Obstetrical Syndrome (GOS) Study

Journal of Obstetrics and Gynaecology Canada ◽

10.1016/j.jogc.2017.11.032 ◽

2018 ◽

Vol 40 (8) ◽

pp. 1044-1049 ◽

Cited By ~ 1

Author(s):

Amélie Boutin ◽

Suzanne Demers ◽

Cédric Gasse ◽

Yves Giguère ◽

Amélie Tétu ◽

...

Keyword(s):

Growth Factor ◽

First Trimester ◽

Placental Growth Factor ◽

First Trimester Screening ◽

Trimester Screening ◽

Fetal Aneuploidies

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202: Adverse pregnancy outcomes among women with low placental growth factor and/or PAPP-A in the enhanced first trimester screening

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2017.10.079 ◽

2018 ◽

Vol 218 (1) ◽

pp. S134

Author(s):

Elad Mei-Dan ◽

Kainat Amir ◽

Wendy Meschino ◽

Nir Melamed ◽

Jon Barrett ◽

...

Keyword(s):

Growth Factor ◽

Pregnancy Outcomes ◽

First Trimester ◽

Placental Growth Factor ◽

Adverse Pregnancy Outcomes ◽

First Trimester Screening ◽

Trimester Screening ◽

Adverse Pregnancy

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First trimester screening for Preeclampsia (PE) using FMF-London-Algorithm with placenta associated plasma protein-a (PAPP-A) and placental growth factor (PlGF)

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0036-1587956 ◽

2016 ◽

Vol 37 (S 01) ◽

Author(s):

C Birdir ◽

A Enekwe ◽

A Iannaccone ◽

J Fryze ◽

A Gellhaus ◽

...

Keyword(s):

Growth Factor ◽

Plasma Protein ◽

Protein A ◽

First Trimester ◽

Placental Growth Factor ◽

First Trimester Screening ◽

Trimester Screening

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Maternal Serum EG-VEGF as A First Trimester Predictor of Hypertensive Disorders of Pregnancy: A Prospective Cohort Study

10.21203/rs.3.rs-156363/v1 ◽

2021 ◽

Author(s):

Shiyu Zeng ◽

Ling Yu ◽

Yiling Ding ◽

Mengyuan Yang

Keyword(s):

Cohort Study ◽

Growth Factor ◽

Prediction Model ◽

Pregnant Women ◽

Predictive Value ◽

Prospective Cohort ◽

First Trimester ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders ◽

Sensitivity Specificity

Abstract Background This study aims to explore whether plasma endocrine gland-derived vascular endothelial growth factor (EG-VEGF) in the first trimester can be used as a predictor of hypertensive disorders of pregnancy (HDP), and compare it with placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) to evaluate its prediction of HDP value. Methods This is a prospective cohort study that records the medical history of the pregnant women included in the study at 11–13 weeks’ gestation, and analyzes serum biochemical markers including EG-VEGF, PIGF, sFlt-1 and sFlt-1/PIGF. The predictive values of these tests were determined. We used the receiver operating characteristic (ROC) curve to find the optimal cut-off value for each biomarker and compare the operating characteristics (sensitivity, specificity). Logistic regression analysis was used to create a prediction model for HDP based on maternal characteristics and maternal biochemistry. Results Data were obtained from 205 pregnant women. 17 cases were diagnosed with HDP, the incidence rate was 8.2% (17/205). Women who developed HDP had a significantly higher body mass index (BMI) and mean arterial pressure (MAP). Serum EG-VEGF levels in the first trimester are significantly higher in pregnant women with HDP. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value(NPV) of serum EG-VEGF levels more than 227.83 pg/ml for predicting HDP were 43%, 93%, 86% and 62%, respectively. We established a prediction model in the first trimester include maternal BMI, MAP, and EG-VEGF, with an AUC of 0.8861 (95%CI: 0.7905–0.9818), which is better than using EG-VEGF alone (AUC: 0.66). Conclusion This study demonstrated that serum EG-VEGF is a promising biomarker for predicting HDP in the first trimester. It has better predictive performance compared with the currently used biomarkers like PIGF and sFlt-1. Combining maternal clinical characteristics and biochemical tests at 11–13 weeks can effectively identify women at high risk of HDP.

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