Prediction of perinatal survival in early‐onset fetal growth restriction: role of placental growth factor

Objective To analyze the ability to predict perinatal survival and severe neonatal morbidity of cases with early-onset fetal growth restriction (eoFGR) using maternal variables, ultrasound parameters and angiogenic markers at the time of diagnosis. Methods This was a prospective observational study...

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Authors: Rodríguez Calvo, Juan, Villalaín González, Cecilia, Gómez Arriaga, Paula Isabel, Quezada, M. S., Herraiz García, Ignacio, Galindo Izquierdo, Alberto
Format: article
Publication Date:2023
Country:España
Institution:Universidad Complutense de Madrid (UCM)
Repository:Docta Complutense
Language:English
OAI Identifier:oai:docta.ucm.es:20.500.14352/72918
Online Access:https://hdl.handle.net/20.500.14352/72918
Access Level:Open access
Keyword:618.2
Early-onset
Fetal growth restriction
FGR
perinatal Survival
PlGF
Ginecología y obstetricia
3201.08 Ginecología
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oai_identifier_str oai:docta.ucm.es:20.500.14352/72918
network_acronym_str ES
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repository_id_str
spelling Prediction of perinatal survival in early‐onset fetal growth restriction: role of placental growth factorRodríguez Calvo, JuanVillalaín González, CeciliaGómez Arriaga, Paula IsabelQuezada, M. S.Herraiz García, IgnacioGalindo Izquierdo, Alberto618.2Early-onsetFetal growth restrictionFGRperinatal SurvivalPlGFGinecología y obstetricia3201.08 GinecologíaObjective To analyze the ability to predict perinatal survival and severe neonatal morbidity of cases with early-onset fetal growth restriction (eoFGR) using maternal variables, ultrasound parameters and angiogenic markers at the time of diagnosis. Methods This was a prospective observational study in a cohort of singleton pregnancies with a diagnosis of eoFGR (< 32 weeks of gestation). At diagnosis of eoFGR, complete assessment was performed, including ultrasound examination (anatomy, biometry and Doppler assessment) and maternal serum measurement of the angiogenic biomarkers, soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF). Logistic regression models for the prediction of perinatal survival (in cases diagnosed at < 28 weeks) and severe neonatal morbidity (in all liveborn cases) were calculated. Results In total, 210 eoFGR cases were included, of which 185 (88.1%) survived perinatally. The median gestational age at diagnosis was 27 + 0 weeks. All cases diagnosed at ≥ 28 weeks survived. In cases diagnosed < 28 weeks, survivors (vs non-survivors) had a higher gestational age (26.1 vs 24.4 weeks), estimated fetal weight (EFW; 626 vs 384 g), cerebroplacental ratio (1.1 vs 0.9), PlGF (41 vs 18 pg/mL) and PlGF multiples of the median (MoM; 0.10 vs 0.06) and lower sFlt-1/PlGF ratio (129 vs 479) at the time of diagnosis (all P < 0.001). The best combination of two variables for predicting perinatal survival was provided by EFW and PlGF MoM (area under the receiver-operating-characteristics curve (AUC), 0.84 (95% CI, 0.75–0.92)). These were also the best variables for predicting severe neonatal morbidity (AUC, 0.73 (95% CI, 0.66–0.80)). Conclusions A model combining EFW and maternal serum PlGF predicts accurately perinatal survival in eoFGR cases diagnosed before 28 weeks of gestation. Prenatal prediction of severe neonatal morbidity in eoFGR cases is modest regardless of the model used. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.Obstetrics and GinecologyUniversidad Complutense de Madrid20232023-11-1220232023-11-12journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfapplication/pdfhttps://hdl.handle.net/20.500.14352/72918reponame:Docta Complutenseinstname:Universidad Complutense de Madrid (UCM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Atribución-NoComercial-SinDerivadas 3.0 Españahttps://creativecommons.org/licenses/by-nc-nd/3.0/es/info:eu-repo/semantics/openAccessoai:docta.ucm.es:20.500.14352/729182026-06-02T12:44:21Z
dc.title.none.fl_str_mv Prediction of perinatal survival in early‐onset fetal growth restriction: role of placental growth factor
title Prediction of perinatal survival in early‐onset fetal growth restriction: role of placental growth factor
spellingShingle Prediction of perinatal survival in early‐onset fetal growth restriction: role of placental growth factor
Rodríguez Calvo, Juan
618.2
Early-onset
Fetal growth restriction
FGR
perinatal Survival
PlGF
Ginecología y obstetricia
3201.08 Ginecología
title_short Prediction of perinatal survival in early‐onset fetal growth restriction: role of placental growth factor
title_full Prediction of perinatal survival in early‐onset fetal growth restriction: role of placental growth factor
title_fullStr Prediction of perinatal survival in early‐onset fetal growth restriction: role of placental growth factor
title_full_unstemmed Prediction of perinatal survival in early‐onset fetal growth restriction: role of placental growth factor
title_sort Prediction of perinatal survival in early‐onset fetal growth restriction: role of placental growth factor
dc.creator.none.fl_str_mv Rodríguez Calvo, Juan
Villalaín González, Cecilia
Gómez Arriaga, Paula Isabel
Quezada, M. S.
Herraiz García, Ignacio
Galindo Izquierdo, Alberto
author Rodríguez Calvo, Juan
author_facet Rodríguez Calvo, Juan
Villalaín González, Cecilia
Gómez Arriaga, Paula Isabel
Quezada, M. S.
Herraiz García, Ignacio
Galindo Izquierdo, Alberto
author_role author
author2 Villalaín González, Cecilia
Gómez Arriaga, Paula Isabel
Quezada, M. S.
Herraiz García, Ignacio
Galindo Izquierdo, Alberto
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad Complutense de Madrid
dc.subject.none.fl_str_mv 618.2
Early-onset
Fetal growth restriction
FGR
perinatal Survival
PlGF
Ginecología y obstetricia
3201.08 Ginecología
topic 618.2
Early-onset
Fetal growth restriction
FGR
perinatal Survival
PlGF
Ginecología y obstetricia
3201.08 Ginecología
description Objective To analyze the ability to predict perinatal survival and severe neonatal morbidity of cases with early-onset fetal growth restriction (eoFGR) using maternal variables, ultrasound parameters and angiogenic markers at the time of diagnosis. Methods This was a prospective observational study in a cohort of singleton pregnancies with a diagnosis of eoFGR (< 32 weeks of gestation). At diagnosis of eoFGR, complete assessment was performed, including ultrasound examination (anatomy, biometry and Doppler assessment) and maternal serum measurement of the angiogenic biomarkers, soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF). Logistic regression models for the prediction of perinatal survival (in cases diagnosed at < 28 weeks) and severe neonatal morbidity (in all liveborn cases) were calculated. Results In total, 210 eoFGR cases were included, of which 185 (88.1%) survived perinatally. The median gestational age at diagnosis was 27 + 0 weeks. All cases diagnosed at ≥ 28 weeks survived. In cases diagnosed < 28 weeks, survivors (vs non-survivors) had a higher gestational age (26.1 vs 24.4 weeks), estimated fetal weight (EFW; 626 vs 384 g), cerebroplacental ratio (1.1 vs 0.9), PlGF (41 vs 18 pg/mL) and PlGF multiples of the median (MoM; 0.10 vs 0.06) and lower sFlt-1/PlGF ratio (129 vs 479) at the time of diagnosis (all P < 0.001). The best combination of two variables for predicting perinatal survival was provided by EFW and PlGF MoM (area under the receiver-operating-characteristics curve (AUC), 0.84 (95% CI, 0.75–0.92)). These were also the best variables for predicting severe neonatal morbidity (AUC, 0.73 (95% CI, 0.66–0.80)). Conclusions A model combining EFW and maternal serum PlGF predicts accurately perinatal survival in eoFGR cases diagnosed before 28 weeks of gestation. Prenatal prediction of severe neonatal morbidity in eoFGR cases is modest regardless of the model used. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023-11-12
2023
2023-11-12
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.14352/72918
url https://hdl.handle.net/20.500.14352/72918
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución-NoComercial-SinDerivadas 3.0 España
https://creativecommons.org/licenses/by-nc-nd/3.0/es/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución-NoComercial-SinDerivadas 3.0 España
https://creativecommons.org/licenses/by-nc-nd/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Obstetrics and Ginecology
publisher.none.fl_str_mv Obstetrics and Ginecology
dc.source.none.fl_str_mv reponame:Docta Complutense
instname:Universidad Complutense de Madrid (UCM)
instname_str Universidad Complutense de Madrid (UCM)
reponame_str Docta Complutense
collection Docta Complutense
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300724

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