Modeling risk for severe adverse outcomes using angiogenic factor measurements in women with suspected preterm preeclampsia

• Published in: Prenatal diagnosis 2015-04, Vol.35 (4), p.386-393
• Main Authors: Palomaki, Glenn E., Haddow, James E., Haddow, Hamish R. M., Salahuddin, Saira, Geahchan, Carl, Cerdeira, Ana Sofia, Verlohren, Stefan, Perschel, Frank H., Horowitz, Gary, Thadhani, Ravi, Karumanchi, S. Ananth, Rana, Sarosh
• Format: Article
• Language: English
• Subjects: Adult; Angiogenesis Inducing Agents; Biomarkers - blood; Birth weight; Female; Humans; Infant, Newborn; Original; Placenta Growth Factor; Pre-Eclampsia - diagnosis; Preeclampsia; Pregnancy; Pregnancy Outcome; Pregnancy Proteins - blood; Risk Assessment; Vascular Endothelial Growth Factor Receptor-1 - blood
• ISSN: 0197-3851; 1097-0223
• DOI: 10.1002/pd.4554

Introduction Preeclampsia (PE) is a pregnancy‐specific syndrome associated with adverse maternal and fetal outcomes. Patient‐specific risks based on angiogenic factors might better categorize those who might have a severe adverse outcome. Methods Women evaluated for suspected PE at a tertiary hospital (2009–2012) had pregnancy outcomes categorized as ‘referent’ or ‘severe’, based solely on maternal/fetal findings. Outcomes that may have been influenced by a PE diagnosis were considered ‘unclassified’. Soluble fms‐like tyrosine kinase (sFlt1) and placental growth factor (PlGF) were subjected to bivariate discriminant modeling, allowing patient‐specific risks to be assigned for severe outcomes. Results Three hundred twenty‐eight singleton pregnancies presented at ≤34.0 weeks' gestation. sFlt1 and PlGF levels were adjusted for gestational age. Risks above 5 : 1 (10‐fold over background) occurred in 77% of severe (95% CI 66 to 87%) and 0.7% of referent (95% CI