Placental growth factor measurements in the assessment of women with suspected preeclampsia: a stratified analysis of the PARROT trial
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Objective
Placental growth factor testing decreases time to recognition of preeclampsia and may reduce severe maternal adverse outcomes. This analysis aims to describe the clinical phenotype of women by PlGF concentration, and to determine the mechanism(s) underpinning the reduction in severe maternal adverse outcomes in the PARROT trial, in order to inform how PlGF testing may be optimally used within clinical management algorithms.
Study design
This was a planned secondary analysis from the PARROT trial that compared revealed PlGF testing and management guidance with usual care in the assessment of women with suspected preterm preeclampsia.
Main outcome measures
Maternal and perinatal outcomes following stratification of women by trial group, and measured PlGF concentration.
Results
1006 women were included. PlGF < 100 pg/ml identified women with more marked hypertension, increased adverse maternal outcomes and preterm delivery rates, and higher rates of small for gestational age infants. There was a reduction in adverse maternal outcomes in women whose results were revealed when PlGF levels were 12–100 pg/ml compared to usual care (3.8% vs 6.9%; aOR 0.15(95% CI 0.03–0.92). There was no significant difference in gestation at delivery between concealed or revealed groups in any PlGF categories.
Conclusion
Low PlGF concentrations are associated with severe preeclampsia. The reduction in severe adverse maternal outcomes may be mediated through quicker diagnosis and intensive surveillance, as recommended by the management algorithm for those at increased risk. PlGF is particularly beneficial in those who test 12–100 pg/ml, as these may be women with silent multi-organ disease who otherwise may go undetected.
Placental growth factor testing decreases time to recognition of preeclampsia and may reduce severe maternal adverse outcomes. This analysis aims to describe the clinical phenotype of women by PlGF concentration, and to determine the mechanism(s) underpinning the reduction in severe maternal adverse outcomes in the PARROT trial, in order to inform how PlGF testing may be optimally used within clinical management algorithms.
Study design
This was a planned secondary analysis from the PARROT trial that compared revealed PlGF testing and management guidance with usual care in the assessment of women with suspected preterm preeclampsia.
Main outcome measures
Maternal and perinatal outcomes following stratification of women by trial group, and measured PlGF concentration.
Results
1006 women were included. PlGF < 100 pg/ml identified women with more marked hypertension, increased adverse maternal outcomes and preterm delivery rates, and higher rates of small for gestational age infants. There was a reduction in adverse maternal outcomes in women whose results were revealed when PlGF levels were 12–100 pg/ml compared to usual care (3.8% vs 6.9%; aOR 0.15(95% CI 0.03–0.92). There was no significant difference in gestation at delivery between concealed or revealed groups in any PlGF categories.
Conclusion
Low PlGF concentrations are associated with severe preeclampsia. The reduction in severe adverse maternal outcomes may be mediated through quicker diagnosis and intensive surveillance, as recommended by the management algorithm for those at increased risk. PlGF is particularly beneficial in those who test 12–100 pg/ml, as these may be women with silent multi-organ disease who otherwise may go undetected.
Date Issued
2021-03
Date Acceptance
2020-10-08
Citation
Pregnancy Hypertension, 2021, 23, pp.41-47
ISSN
2210-7789
Publisher
Elsevier BV
Start Page
41
End Page
47
Journal / Book Title
Pregnancy Hypertension
Volume
23
Copyright Statement
© 2020 The Authors. Published by Elsevier B.V. on behalf of International Society for the Study of Hypertension in Pregnancy. This is an open access
article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
License URL
Identifier
https://www.sciencedirect.com/science/article/pii/S2210778920301306?via%3Dihub
Subjects
1114 Paediatrics and Reproductive Medicine
Publication Status
Published online
Date Publish Online
2020-10-18