Maternal plasma concentrations of angiogenic/anti-angiogenic factors are of prognostic value in patients presenting to the obstetrical triage area with the suspicion of preeclampsia

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dc.contributor.authorChaiworapongsa, Tinnakorn
dc.contributor.authorRomero, Roberto
dc.contributor.authorSavasan, Zeynep Alpay
dc.contributor.authorKusanovic, Juan Pedro
dc.contributor.authorOgge, Giovanna
dc.contributor.authorSoto, Eleazar
dc.contributor.authorDong, Zhong
dc.contributor.authorTarca, Adi
dc.contributor.authorGaurav, Bhatti
dc.contributor.authorHassan, Sonia S.
dc.date.accessioned2024-01-10T13:14:41Z
dc.date.available2024-01-10T13:14:41Z
dc.date.issued2011
dc.description.abstractObjective: To determine whether maternal plasma concentrations of placental growth factor (PlGF), soluble endoglin (sEng), soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and -2 could identify patients at risk for developing preeclampsia (PE) requiring preterm delivery. Study design: Patients presenting with the diagnosis "rule out PE" to the obstetrical triage area of our hospital at <37 weeks of gestation (n = 87) were included in this study. Delivery outcomes were used to classify patients into four groups: I) patients without PE or those with gestational hypertension (GHTN) or chronic hypertension (CHTN) who subsequently developed PE at term (n = 19); II): mild PE who delivered at term (n = 15); III): mild disease (mild PE, GHTN, CHTN) who subsequently developed severe PE requiring preterm delivery (n = 26); and IV): diagnosis of severe PE (n = 27). Plasma concentrations of PlGF, sEng, sVEGFR-1 and -2 were determined at the time of presentation by ELISA. Reference ranges for analytes were constructed by quantile regression in our laboratory (n = 180; 1046 samples). Comparisons among groups were performed using multiples of the median (MoM) and parametric statistics after log transformation. Receiver operating characteristic curves, logistic regression and survival analysis were employed for analysis. Results: The mean MoM plasma concentration of PlGF/sVEGFR-1, PlGF/sEng, PlGF, sVEGFR-1 and -2, and sEng in Group III was significantly different from Group II (all p<0.05). A plasma concentration of PlGF/sVEGFR-1 <= 0.05 MoM or PlGF/sEng <= 0.07 MoM had the highest likelihood ratio of a positive test (8.3, 95% CI 2.8-25 and 8.6, 95% CI 2.9-25, respectively), while that of PlGF <= 0.396 MoM had the lowest likelihood ratio of a negative test (0.08, 95% CI 0.03-0.25). The association between low plasma concentrations of PlGF/sVEGFR-1 (= 0.05 MoM) as well as that of PlGF/sEng (= 0.07 MoM) and the development of severe PE remained significant after adjusting for gestational age at presentation, average systolic and diastolic blood pressure, and a history of chronic hypertension [ adjusted odds ratio (OR) = 27 (95% CI 6.4-109) and adjusted OR 30 (95% CI 6.9-126), respectively]. Among patients who presented < 34 weeks gestation (n = 59), a plasma concentration of PlGF/sVEGFR-1 < 0.033 MoM identified patients who delivered within 2 weeks because of PE with a sensitivity of 93% (25/27) and a specificity of 78% (25/32). This cut-off was associated with a shorter interval-to-delivery due to PE [ hazard ratio = 6 (95% CI 2.5-14.6)]. Conclusions: Plasma concentrations of angiogenic/anti-angiogenic factors are of prognostic value in the obstetrical triage area. These observations support the value of these biomarkers in the clinical setting for the identification of the patient at risk for disease progression requiring preterm delivery.
dc.description.funderPerinatology Research Branch, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS
dc.description.funderEUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT
dc.description.funderEUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH &HUMAN DEVELOPMENT
dc.fechaingreso.objetodigital2024-05-13
dc.format.extent21 páginas
dc.fuente.origenWOS
dc.identifier.doi10.3109/14767058.2011.589932
dc.identifier.eissn1476-4954
dc.identifier.issn1476-7058
dc.identifier.pubmedidMEDLINE:21827221
dc.identifier.urihttps://doi.org/10.3109/14767058.2011.589932
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/78431
dc.identifier.wosidWOS:000295040500001
dc.information.autorucMedicina;Kusanovic J;S/I;1008900
dc.issue.numero10
dc.language.isoen
dc.nota.accesoSin adjunto
dc.pagina.final1207
dc.pagina.inicio1187
dc.publisherTAYLOR & FRANCIS LTD
dc.revistaJOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
dc.rightsregistro bibliográfico
dc.subjectautomated assay
dc.subjectIUGR
dc.subjectPlacental growth factor (PlGF)
dc.subjectpreterm labor
dc.subjectsoluble endoglin (sEng)
dc.subjectsoluble vascular endothelial growth factor receptor-1 (sVEGFR-1)
dc.subjectsoluble vascular endothelial growth factor receptor-2 (sVEGFR-2)
dc.subjectangiogenesis
dc.subjectsflt-1
dc.subjectENDOTHELIAL GROWTH-FACTOR
dc.subjectFOR-GESTATIONAL-AGE
dc.subjectLOW-DOSE ASPIRIN
dc.subjectCIRCULATING ANTIANGIOGENIC FACTORS
dc.subjectFACTOR RECEPTOR-1 CONCENTRATION
dc.subjectPREGNANCY-INDUCED HYPERTENSION
dc.subjectADVERSE PERINATAL OUTCOMES
dc.subjectPROTEIN-CREATININE RATIO
dc.subjectUNEXPLAINED FETAL-DEATH
dc.subjectINNATE-IMMUNE-SYSTEM
dc.subject.ods05 Gender Equality
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa05 Igualdad de género
dc.subject.odspa03 Salud y bienestar
dc.titleMaternal plasma concentrations of angiogenic/anti-angiogenic factors are of prognostic value in patients presenting to the obstetrical triage area with the suspicion of preeclampsia
dc.typeartículo
dc.volumen24
sipa.codpersvinculados1008900
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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