RT Journal Article
T1 Prediction of perinatal survival in early‐onset fetal growth restriction: role of placental growth factor
A1 Rodríguez Calvo, Jesús
A1 Villalaín González, Cecilia
A1 Gómez Arriaga, Paula Isabel
A1 Quezada Rojas, María Soledad
A1 Herraiz García, Ignacio
A1 Galindo Izquierdo, Alberto
AB ObjectiveTo 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.MethodsThis 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.ResultsIn 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)).ConclusionsA 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.
PB Wiley
SN 0960-7692
SN 1469-0705
YR 2023
FD 2023-02
LK https://hdl.handle.net/20.500.14352/106028
UL https://hdl.handle.net/20.500.14352/106028
LA eng
NO Rodríguez-Calvo J, Villalaín C, Gómez-Arriaga PI, Quezada MS, Herraiz I, Galindo A. Prediction of perinatal survival in early-onset fetal growth restriction: role of placental growth factor. Ultrasound Obstet Gynecol. 2023 Feb;61(2):181-190. doi: 10.1002/uog.26116.
NO Fondos FEDER
NO European Commission
NO Ministerio de Economía, Industria y Competitividad (España)
NO Instituto de Salud Carlos III (España)
DS Docta Complutense
RD 11 abr 2025