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Maternal PlGF and umbilical Dopplers predict pregnancy outcomes at diagnosis of early-onset fetal growth restriction

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Maternal PlGF and umbilical Dopplers predict pregnancy outcomes at diagnosis of early-onset fetal growth restriction. / Spencer, Rebecca; Maksym, Kasia; Hecher, Kurt; Maršál, Karel; Figueras, Francesc; Ambler, Gareth; Whitwell, Harry; Nené, Nuno Rocha; Sebire, Neil J; Hansson, Stefan R; Diemert, Anke; Brodszki, Jana; Gratacós, Eduard; Ginsberg, Yuval; Weissbach, Tal; Peebles, Donald M; Zachary, Ian; Marlow, Neil; Huertas-Ceballos, Angela; David, Anna L.

In: J CLIN INVEST, Vol. 133, No. 18, e169199, 15.09.2023.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Spencer, R, Maksym, K, Hecher, K, Maršál, K, Figueras, F, Ambler, G, Whitwell, H, Nené, NR, Sebire, NJ, Hansson, SR, Diemert, A, Brodszki, J, Gratacós, E, Ginsberg, Y, Weissbach, T, Peebles, DM, Zachary, I, Marlow, N, Huertas-Ceballos, A & David, AL 2023, 'Maternal PlGF and umbilical Dopplers predict pregnancy outcomes at diagnosis of early-onset fetal growth restriction', J CLIN INVEST, vol. 133, no. 18, e169199. https://doi.org/10.1172/JCI169199

APA

Spencer, R., Maksym, K., Hecher, K., Maršál, K., Figueras, F., Ambler, G., Whitwell, H., Nené, N. R., Sebire, N. J., Hansson, S. R., Diemert, A., Brodszki, J., Gratacós, E., Ginsberg, Y., Weissbach, T., Peebles, D. M., Zachary, I., Marlow, N., Huertas-Ceballos, A., & David, A. L. (2023). Maternal PlGF and umbilical Dopplers predict pregnancy outcomes at diagnosis of early-onset fetal growth restriction. J CLIN INVEST, 133(18), [e169199]. https://doi.org/10.1172/JCI169199

Vancouver

Spencer R, Maksym K, Hecher K, Maršál K, Figueras F, Ambler G et al. Maternal PlGF and umbilical Dopplers predict pregnancy outcomes at diagnosis of early-onset fetal growth restriction. J CLIN INVEST. 2023 Sep 15;133(18). e169199. https://doi.org/10.1172/JCI169199

Bibtex

@article{650cd2e3cc354dbf9354728e9a30059d,
title = "Maternal PlGF and umbilical Dopplers predict pregnancy outcomes at diagnosis of early-onset fetal growth restriction",
abstract = "BACKGROUNDSevere, early-onset fetal growth restriction (FGR) causes significant fetal and neonatal mortality and morbidity. Predicting the outcome of affected pregnancies at the time of diagnosis is difficult, thus preventing accurate patient counseling. We investigated the use of maternal serum protein and ultrasound measurements at diagnosis to predict fetal or neonatal death and 3 secondary outcomes: fetal death or delivery at or before 28+0 weeks, development of abnormal umbilical artery (UmA) Doppler velocimetry, and slow fetal growth.METHODSWomen with singleton pregnancies (n = 142, estimated fetal weights [EFWs] below the third centile, less than 600 g, 20+0 to 26+6 weeks of gestation, no known chromosomal, genetic, or major structural abnormalities) were recruited from 4 European centers. Maternal serum from the discovery set (n = 63) was analyzed for 7 proteins linked to angiogenesis, 90 additional proteins associated with cardiovascular disease, and 5 proteins identified through pooled liquid chromatography and tandem mass spectrometry. Patient and clinician stakeholder priorities were used to select models tested in the validation set (n = 60), with final models calculated from combined data.RESULTSThe most discriminative model for fetal or neonatal death included the EFW z score (Hadlock 3 formula/Marsal chart), gestational age, and UmA Doppler category (AUC, 0.91; 95% CI, 0.86-0.97) but was less well calibrated than the model containing only the EFW z score (Hadlock 3/Marsal). The most discriminative model for fetal death or delivery at or before 28+0 weeks included maternal serum placental growth factor (PlGF) concentration and UmA Doppler category (AUC, 0.89; 95% CI, 0.83-0.94).CONCLUSIONUltrasound measurements and maternal serum PlGF concentration at diagnosis of severe, early-onset FGR predicted pregnancy outcomes of importance to patients and clinicians.TRIAL REGISTRATIONClinicalTrials.gov NCT02097667.FUNDINGThe European Union, Rosetrees Trust, Mitchell Charitable Trust.",
keywords = "Female, Humans, Infant, Newborn, Pregnancy, Fetal Death, Fetal Growth Retardation/diagnostic imaging, Perinatal Death, Placenta Growth Factor, Pregnancy Outcome",
author = "Rebecca Spencer and Kasia Maksym and Kurt Hecher and Karel Mar{\v s}{\'a}l and Francesc Figueras and Gareth Ambler and Harry Whitwell and Nen{\'e}, {Nuno Rocha} and Sebire, {Neil J} and Hansson, {Stefan R} and Anke Diemert and Jana Brodszki and Eduard Gratac{\'o}s and Yuval Ginsberg and Tal Weissbach and Peebles, {Donald M} and Ian Zachary and Neil Marlow and Angela Huertas-Ceballos and David, {Anna L}",
year = "2023",
month = sep,
day = "15",
doi = "10.1172/JCI169199",
language = "English",
volume = "133",
journal = "J CLIN INVEST",
issn = "0021-9738",
publisher = "The American Society for Clinical Investigation",
number = "18",

}

RIS

TY - JOUR

T1 - Maternal PlGF and umbilical Dopplers predict pregnancy outcomes at diagnosis of early-onset fetal growth restriction

AU - Spencer, Rebecca

AU - Maksym, Kasia

AU - Hecher, Kurt

AU - Maršál, Karel

AU - Figueras, Francesc

AU - Ambler, Gareth

AU - Whitwell, Harry

AU - Nené, Nuno Rocha

AU - Sebire, Neil J

AU - Hansson, Stefan R

AU - Diemert, Anke

AU - Brodszki, Jana

AU - Gratacós, Eduard

AU - Ginsberg, Yuval

AU - Weissbach, Tal

AU - Peebles, Donald M

AU - Zachary, Ian

AU - Marlow, Neil

AU - Huertas-Ceballos, Angela

AU - David, Anna L

PY - 2023/9/15

Y1 - 2023/9/15

N2 - BACKGROUNDSevere, early-onset fetal growth restriction (FGR) causes significant fetal and neonatal mortality and morbidity. Predicting the outcome of affected pregnancies at the time of diagnosis is difficult, thus preventing accurate patient counseling. We investigated the use of maternal serum protein and ultrasound measurements at diagnosis to predict fetal or neonatal death and 3 secondary outcomes: fetal death or delivery at or before 28+0 weeks, development of abnormal umbilical artery (UmA) Doppler velocimetry, and slow fetal growth.METHODSWomen with singleton pregnancies (n = 142, estimated fetal weights [EFWs] below the third centile, less than 600 g, 20+0 to 26+6 weeks of gestation, no known chromosomal, genetic, or major structural abnormalities) were recruited from 4 European centers. Maternal serum from the discovery set (n = 63) was analyzed for 7 proteins linked to angiogenesis, 90 additional proteins associated with cardiovascular disease, and 5 proteins identified through pooled liquid chromatography and tandem mass spectrometry. Patient and clinician stakeholder priorities were used to select models tested in the validation set (n = 60), with final models calculated from combined data.RESULTSThe most discriminative model for fetal or neonatal death included the EFW z score (Hadlock 3 formula/Marsal chart), gestational age, and UmA Doppler category (AUC, 0.91; 95% CI, 0.86-0.97) but was less well calibrated than the model containing only the EFW z score (Hadlock 3/Marsal). The most discriminative model for fetal death or delivery at or before 28+0 weeks included maternal serum placental growth factor (PlGF) concentration and UmA Doppler category (AUC, 0.89; 95% CI, 0.83-0.94).CONCLUSIONUltrasound measurements and maternal serum PlGF concentration at diagnosis of severe, early-onset FGR predicted pregnancy outcomes of importance to patients and clinicians.TRIAL REGISTRATIONClinicalTrials.gov NCT02097667.FUNDINGThe European Union, Rosetrees Trust, Mitchell Charitable Trust.

AB - BACKGROUNDSevere, early-onset fetal growth restriction (FGR) causes significant fetal and neonatal mortality and morbidity. Predicting the outcome of affected pregnancies at the time of diagnosis is difficult, thus preventing accurate patient counseling. We investigated the use of maternal serum protein and ultrasound measurements at diagnosis to predict fetal or neonatal death and 3 secondary outcomes: fetal death or delivery at or before 28+0 weeks, development of abnormal umbilical artery (UmA) Doppler velocimetry, and slow fetal growth.METHODSWomen with singleton pregnancies (n = 142, estimated fetal weights [EFWs] below the third centile, less than 600 g, 20+0 to 26+6 weeks of gestation, no known chromosomal, genetic, or major structural abnormalities) were recruited from 4 European centers. Maternal serum from the discovery set (n = 63) was analyzed for 7 proteins linked to angiogenesis, 90 additional proteins associated with cardiovascular disease, and 5 proteins identified through pooled liquid chromatography and tandem mass spectrometry. Patient and clinician stakeholder priorities were used to select models tested in the validation set (n = 60), with final models calculated from combined data.RESULTSThe most discriminative model for fetal or neonatal death included the EFW z score (Hadlock 3 formula/Marsal chart), gestational age, and UmA Doppler category (AUC, 0.91; 95% CI, 0.86-0.97) but was less well calibrated than the model containing only the EFW z score (Hadlock 3/Marsal). The most discriminative model for fetal death or delivery at or before 28+0 weeks included maternal serum placental growth factor (PlGF) concentration and UmA Doppler category (AUC, 0.89; 95% CI, 0.83-0.94).CONCLUSIONUltrasound measurements and maternal serum PlGF concentration at diagnosis of severe, early-onset FGR predicted pregnancy outcomes of importance to patients and clinicians.TRIAL REGISTRATIONClinicalTrials.gov NCT02097667.FUNDINGThe European Union, Rosetrees Trust, Mitchell Charitable Trust.

KW - Female

KW - Humans

KW - Infant, Newborn

KW - Pregnancy

KW - Fetal Death

KW - Fetal Growth Retardation/diagnostic imaging

KW - Perinatal Death

KW - Placenta Growth Factor

KW - Pregnancy Outcome

U2 - 10.1172/JCI169199

DO - 10.1172/JCI169199

M3 - SCORING: Journal article

C2 - 37712421

VL - 133

JO - J CLIN INVEST

JF - J CLIN INVEST

SN - 0021-9738

IS - 18

M1 - e169199

ER -