American Journal of Obstetrics and Gynecology
ResearchObstetricsCan placental growth factor in maternal circulation identify fetuses with placental intrauterine growth restriction?
Section snippets
Study population
In this retrospective case-control study, blood samples were prospectively collected from women with singleton pregnancies diagnosed antenatally with IUGR following written informed consent, between November 2004 and August 2007 at BC Women's Hospital in Vancouver, Canada. Ethics approval was granted by the University of British Columbia Children's and Women's Health Centre Research Ethics Boards. Other data pertaining to this cohort of women have previously been published.19, 20, 21, 22
Clinical characteristics
Baseline and outcomes characteristics of women having fetuses with placental IUGR, women with constitutionally small fetuses, and normal pregnancy controls are shown in Table 1. Matching criteria between all groups did not differ, although sampling in women with placental IUGR tended to occur earlier in gestation (P = .04). Parity did not vary between the groups, and all women had singleton pregnancies and were normotensive at the time of booking. No women were smokers at the time of sampling.
Comment
We have shown that PlGF levels in maternal circulation may have the potential to identify placental IUGR antenatally. A positive PlGF test result on the automated Triage PlGF assay (concentration below the fifth percentile for gestational age for a normal pregnancy) (Alere San Diego) was more common in women with placental IUGR than women with constitutionally small fetuses or normal pregnancies. We have also shown that a positive PlGF test identifies placental IUGR from constitutionally small
Conclusion
Our preliminary data suggest that PlGF measured on the Triage assay (Alere San Diego) differentiates placental IUGR from constitutionally small fetuses with high sensitivity and specificity. Further studies are needed to support PlGF as a useful biomarker in the identification of placental IUGR.
Acknowledgments
Direct research assistance was received from Pamela Lutley, Tara Morris, Céline Basque, and Monica Pearson. We gratefully acknowledge the support of Dr David P. Speert with the original funding application and study design and Dr Jennifer Hutcheon for her statistical input.
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This study was supported by a New Investigator Pilot Project Grant from the Institute of Infection and Immunity, Canadian Institutes of Health Research (P.v.D.), and funded in part by Alere International. Additional funding was derived from salary awards from the Michael Smith Foundation for Health Research (L.A.M. and P.v.D.), Canadian Institutes of Health Research (P.v.D.), and the Child and Family Research Institute (P.v.D. and S.B.).
P.v.D. is a principal investigator for an investigator-initiated safety and efficacy trial of a possible disease-modifying therapy for preeclampsia sponsored by Eli Lilly, Canada, and is a site investigator for a preeclampsia prediction study sponsored by Alere International. He is also a consultant for Alere International. K.K. is an employee of Alere San Diego. S.-W.L. is a former employee of Alere San Diego.
Cite this article as: Benton SJ, Hu Y, Xie F, et al. Can placental growth factor in maternal circulation identify fetuses with placental intrauterine growth restriction? Am J Obstet Gynecol 2012;206:163.e1-7.