First trimester prediction and prevention of adverse pregnancy outcomes related to poor placentation

D’Silva, Arlene M; Fyfe, Rina; Hyett, Jon

doi:10.1097/gco.0000000000000420

Cited by 10 publications

(8 citation statements)

References 53 publications

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“…Most notably, the present study relied on a fairly small number of cases and controls ( n = 400). While the case number used in the present study is larger than those used to create other tests [ 21 – 23 ] it is still far too small to make firm conclusions about broad testing efficacy and performance. Also, because the current study relied on a population-based sampling design that reflected the true distribution of women participating in prenatal screening by race/ethnicity grouping, we were not powered to look at performance by all race/ethnicity groupings.…”

Section: Discussionmentioning

confidence: 97%

“…Currently these tests focus mostly on spontaneous PTB (PTB related to preterm premature rupture of membranes (PPROM) or premature labor) and generally do not address provider initiated PTB (PTB resulting from cesarean section or induction due to fetal or maternal indication). Efforts focused on molecular and other prediction testing for preeeclampsia are also well underway but also rarely address overlap with efforts aimed at predicting PTB [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

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Prediction of preterm birth with and without preeclampsia using mid-pregnancy immune and growth-related molecular factors and maternal characteristics

et al. 2018

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Objective:To evaluate if mid-pregnancy immune and growth-related molecular factors predict preterm birth (PTB) with and without (±) preeclampsia.Study design:Included were 400 women with singleton deliveries in California in 2009–2010 (200 PTB and 200 term) divided into training and testing samples at a 2:1 ratio. Sixty-three markers were tested in 15–20 serum samples using multiplex technology. Linear discriminate analysis was used to create a discriminate function. Model performance was assessed using area under the receiver operating characteristic curve (AUC).Results:Twenty-five serum biomarkers along with maternal age <34 years and poverty status identified >80% of women with PTB ± preeclampsia with best performance in women with preterm preeclampsia (AUC = 0.889, 95% confidence interval (0.822–0.959) training; 0.883 (0.804–0.963) testing).Conclusion:Together with maternal age and poverty status, mid-pregnancy immune and growth factors reliably identified most women who went on to have a PTB ± preeclampsia.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Prediction of preterm birth with and without preeclampsia using mid-pregnancy immune and growth-related molecular factors and maternal characteristics

et al. 2018

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“…The statistical approach used in PE screening and in the first trimester combined screening for aneuploidies has also been applied in prediction models for other adverse obstetric outcomes such as fetal growth restriction (FGR) and stillbirth, but performance of the models has been less effective to date. In addition, the multivariable algorithms that are used are typically complex and require large independent populations for validation, which is resource- and time-consuming [7].…”

Section: Introductionmentioning

confidence: 99%

Placental Growth Factor and Adverse Obstetric Outcomes in a Mixed-Risk Cohort of Women Screened for Preeclampsia in the First Trimester of Pregnancy

et al. 2021

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Objective: The study aimed to investigate the association between placental growth factor (PlGF) and adverse obstetric outcomes in a mixed-risk cohort of pregnant women screened for preeclampsia (PE) in the first trimester. Methods: We included women with singleton pregnancies screened for PE between April 2014 and September 2016. Outcome data were retrieved from the New South Wales Perinatal Data Collection (NSW PDC) by linkage to the prenatal cohort. Adverse outcomes were defined as spontaneous preterm birth (sPTB) before 37-week gestation, birth weight (BW) below the 3rd centile, PE, gestational hypertension (GH), stillbirth, and neonatal death. Results: The cohort consisted of 11,758 women. PlGF multiple of the median (MoM) was significantly associated with maternal sociodemographic characteristics (particularly smoking status and parity) and all biomarkers used in the PE first trimester screening model (notably pregnancy-associated plasma protein A MoM and uterine artery pulsatility index [PI] MoM). Low levels of PlGF (<0.3 MoM and <0.5 MoM) were independently associated with sPTB, low BW, PE, GH, and a composite adverse pregnancy outcome score, with odds ratios between 1.81 and 4.44 on multivariable logistic regression analyses. Conclusions: Low PlGF MoM levels are independently associated with PE and a range of other adverse pregnancy outcomes. Inclusion of PlGF should be considered in future models screening for adverse pregnancy outcomes in the first trimester.

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“…Fetal growth restriction (FGR) is a serious condition defined as the failure of the fetus to reach its genetic growth potential [1]. Fetal development restriction starting after week 32 is called late-onset FGR [2].…”

Section: Introductionmentioning

confidence: 99%

“…Fetal development restriction starting after week 32 is called late-onset FGR [2]. Approximately thirty million babies are born each year with this diagnosis [1]. FGR is an important cause of prenatal morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Can Inflammatory Hematological Parameters be a Guide to Late-onset Fetal Growth Restriction?

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et al. 2020

Z Geburtshilfe Neonatol

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Purpose To compare the rates obtained from hematological parameters in cases of late-onset idiopathic fetal growth restriction (FGR) with healthy pregnancies and to evaluate the effect on neonatal outcomes. Methods The study group consisted of 63 pregnant women with late-onset idiopathic FGR and the control group consisted of 91 healthy pregnant women. The determined rates were calculated from the control hemograms of patients at 28 weeks. Both groups were compared for neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and other parameters. Results NLR, leukocyte and neutrophil levels were significantly higher in the FGR group (p<0.05). There was no significant difference in PLR, platelet and lymphocyte levels between the groups (p>0.05). To predict FGR, the best cut-off value of NLR was determined to be 4.11 with 56% sensitivity and 88% specificity values. Conclusion Neutrophil, lymphocyte and platelet interactions have an important role in FGR development. Inflammation can be involved in the etiopathogenesis in late-onset FGR.

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First trimester prediction and prevention of adverse pregnancy outcomes related to poor placentation

Abstract: Significant progress has been made in developing predictive and preventive strategies which can affect the prevalence of severe early-onset preeclampsia. This approach could be adopted for population-based screening aiming to prevent this disease.

Cited by 10 publications

References 53 publications

Prediction of preterm birth with and without preeclampsia using mid-pregnancy immune and growth-related molecular factors and maternal characteristics

Prediction of preterm birth with and without preeclampsia using mid-pregnancy immune and growth-related molecular factors and maternal characteristics

Placental Growth Factor and Adverse Obstetric Outcomes in a Mixed-Risk Cohort of Women Screened for Preeclampsia in the First Trimester of Pregnancy

Can Inflammatory Hematological Parameters be a Guide to Late-onset Fetal Growth Restriction?

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