762: Risk for preeclampsia and intrauterine growth restriction: effective value of PlGF, Sflt-1 and Inhibin A in singleton and multiple pregnancies

Boucoiran, Isabelle; Thissier-Levy, Sarah; Wu, Yuquan; Wei, Shu Qin; Luo, Zuojie; Delvin, Edgard; Fraser, William D.; Audibert, François

doi:10.1016/j.ajog.2011.10.780

Cited by 4 publications

(2 citation statements)

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“…In all, 162 studies were excluded, the main reasons being the lack of data to construct 2 × 2 tables (43%) and not being a test accuracy study (25%). Fifty‐three studies including 39 974 women, evaluating a total of 37 novel biomarkers, met the inclusion criteria . Box lists novel biomarkers for predicting IUGR that were identified in this review.…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies reported data on placental growth factor (PlGF), [32][33][34][35]37,38,[40][41][42][43][44][45][46] three on soluble fms-like tyrosine kinase-1, 38,40,43 two on soluble endoglin, 41,43 and one each on vascular endothelial growth factor 36 and angiopoietin-2. 39 Figure 3 shows the summary ROC curves of PlGF for predicting IUGR.…”

Section: Angiogenesis-related Biomarkersmentioning

confidence: 99%

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Novel biomarkers for predicting intrauterine growth restriction: a systematic review and meta‐analysis

Conde-Agudelo

Papageorghiou

Kennedy

et al. 2013

BJOG

130

101

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Background Several biomarkers for predicting intrauterine growth restriction (IUGR) have been proposed in recent years. However, the predictive performance of these biomarkers has not been systematically evaluated.Objective To determine the predictive accuracy of novel biomarkers for IUGR in women with singleton gestations.Search strategy Electronic databases, reference list checking and conference proceedings.Selection criteria Observational studies that evaluated the accuracy of novel biomarkers proposed for predicting IUGR.Data collection and analysis Data were extracted on characteristics, quality and predictive accuracy from each study to construct 2 9 2 tables. Summary receiver operating characteristic curves, sensitivities, specificities and likelihood ratios (LRs) were generated.Main results A total of 53 studies, including 39 974 women and evaluating 37 novel biomarkers, fulfilled the inclusion criteria. Overall, the predictive accuracy of angiogenic factors for IUGR was minimal (median pooled positive and negative LRs of 1.7, range 1.0-19.8; and 0.8, range 0.0-1.0, respectively). Two small case-control studies reported high predictive values for placental growth factor and angiopoietin-2 only when IUGR was defined as birthweight centile with clinical or pathological evidence of fetal growth restriction. Biomarkers related to endothelial function/ oxidative stress, placental protein/hormone, and others such as serum levels of vitamin D, urinary albumin : creatinine ratio, thyroid function tests and metabolomic profile had low predictive accuracy.Conclusions None of the novel biomarkers evaluated in this review are sufficiently accurate to recommend their use as predictors of IUGR in routine clinical practice. However, the use of biomarkers in combination with biophysical parameters and maternal characteristics could be more useful and merits further research.

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Section: Resultsmentioning

confidence: 99%

Section: Angiogenesis-related Biomarkersmentioning

confidence: 99%

Novel biomarkers for predicting intrauterine growth restriction: a systematic review and meta‐analysis

Conde-Agudelo

Papageorghiou

Kennedy

et al. 2013

BJOG

130

101

View full text Add to dashboard Cite

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Biochemical tests of placental function versus ultrasound assessment of fetal size for stillbirth and small-for-gestational-age infants

Heazell

Hayes

Whitworth

et al. 2019

Cochrane Database of Systematic Reviews

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Screening for fetal growth restriction using fetal biometry combined with maternal biomarkers

Gaccioli

Aye

Sovio

et al. 2018

American Journal of Obstetrics and Gynecology

126

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Fetal growth restriction is a major determinant of perinatal morbidity and mortality. Screening for fetal growth restriction is a key element of prenatal care but it is recognized to be problematic. Screening using clinical risk assessment and targeting ultrasound to high-risk women is the standard of care in the United States and United Kingdom, but the approach is known to have low sensitivity. Systematic reviews of randomized controlled trials do not demonstrate any benefit from universal ultrasound screening for fetal growth restriction in the third trimester, but the evidence base is not strong. Implementation of universal ultrasound screening in low-risk women in France failed to reduce the risk of complications among small-for-gestational-age infants but did appear to cause iatrogenic harm to false positives. One strategy to making progress is to improve screening by developing more sensitive and specific tests with the key goal of differentiating between healthy small fetuses and those that are small through fetal growth restriction. As abnormal placentation is thought to be the major cause of fetal growth restriction, one approach is to combine fetal biometry with an indicator of placental dysfunction. In the past, these indicators were generally ultrasonic measurements, such as Doppler flow velocimetry of the uteroplacental circulation. However, another promising approach is to combine ultrasonic suspicion of small-for-gestational-age infant with a blood test indicating placental dysfunction. Thus far, much of the research on maternal serum biomarkers for fetal growth restriction has involved the secondary analysis of tests performed for other indications, such as fetal aneuploidies. An exemplar of this is pregnancy-associated plasma protein A. This blood test is performed primarily to assess the risk of Down syndrome, but women with low first-trimester levels are now serially scanned in later pregnancy due to associations with placental causes of stillbirth, including fetal growth restriction. The development of "omic" technologies presents a huge opportunity to identify novel biomarkers for fetal growth restriction. The hope is that when such markers are measured alongside ultrasonic fetal biometry, the combination would have strong predictive power for fetal growth restriction and its related complications. However, a series of important methodological considerations in assessing the diagnostic effectiveness of new tests will have to be addressed. The challenge thereafter will be to identify novel disease-modifying interventions, which are the essential partner to an effective screening test to achieve clinically effective population-based screening.

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762: Risk for preeclampsia and intrauterine growth restriction: effective value of PlGF, Sflt-1 and Inhibin A in singleton and multiple pregnancies

Cited by 4 publications

References 0 publications

Novel biomarkers for predicting intrauterine growth restriction: a systematic review and meta‐analysis

Novel biomarkers for predicting intrauterine growth restriction: a systematic review and meta‐analysis

Biochemical tests of placental function versus ultrasound assessment of fetal size for stillbirth and small-for-gestational-age infants

Screening for fetal growth restriction using fetal biometry combined with maternal biomarkers

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