Association of serum placental growth factor and pregnancy associated plasma protein A between 11 to 14 weeks and pre-eclampsia

Authors

  • Namrata Kumar Department of Obstetrics and Gynecology, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Vinita Das Department of Obstetrics and Gynecology, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Anjoo Agrawal Department of Obstetrics and Gynecology, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Amita Pandey Department of Obstetrics and Gynecology, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Smriti Agrawal Department of Obstetrics and Gynecology, King George’s Medical University, Lucknow, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20211513

Keywords:

PAPPA, PlGF, Preeclampsia

Abstract

Background: Pre eclampsia complicates around 5-10% of pregnancies worldwide. Many countries in the world are far away of having interventions to predict and prevent preeclampsia. A number of biochemical, biophysical and sonographic parameters are emerging as a potential tool which can help us in a long way. This study was aimed to study association of biochemical markers of preeclampsia in early pregnancy with the development of preeclampsia.

Methods: This cohort study was conducted over a period of one year in the Department of Obstetrics and Gynecology at King George’s Medical University, Lucknow.

Results: Total number of women enrolled at 11-14 weeks were 56. The mean age of women enrolled was 28±4.2 years. Out of total 44.6% women were nulliparous. Mean crown rump length at testing was 60.55±11.26mm. There was a significant correlation between the levels of Placental growth factors and development of PE (p<0.01) and especially severe early onset disease, however we did not found a significant correlation between Pregnancy associated plasma protein and Preeclampsia.

Conclusions: Placental growth factor is an emerging marker which could be incorporated in essential bundle of care at 11 to 14 weeks testing in order to enhance the detection rates of preeclampsia.

References

Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams obstetrics 24th ed. USA. 2014.

American College of Obstetricians and Gynaecologists. Task Force on Hypertension in Pregnancy, Hypertension in Pregnancy/Developed by Task Force on Hypertension in Pregnancy. 2014.

Yu CKH, Khouri O, Onwudiwe N, Spiliopoulos Y, Nicolaides KH. Prediction of pre-eclampsia by uterine artery Doppler imaging: relationship to gestational age at delivery and small for gestational age. Ultrasound Obstet Gynecol. 2008;31(3):310-3.

Walsh CA, Bakshi LV. Mean arterial pressure and prediction of pre-eclampsia. Br Med J. 2008;336(7653):1079-80.

Akolekar R, Syngelaki A, Sarquis R, Zvanca M, Nicolaides KH. Prediction of early, intermediate and late preeclampsia from maternal factors, biophysical and biochemical markers at 11-13 weeks. Prenatal diagnosis. 2011;31(1):66-74.

Goetzinger KR, Singla A, Gerkowicz S, Dicke JM, Gray DL, Odibo AO. Predicting the risk of pre-eclampsia between 11 and 13 weeks gestation by combining maternal characteristics and serum analytes, PAPP-A and free beta-Hcg. Prenatal Diag. 2010;30(12-3):1138-42.

Plasencia W, Maiz N, Bonino S, Kaihura C, Nicolaides KH. Uterine artery Doppler at 11+0 to 13+6 weeks in the prediction of pre-eclampsia. Ultrasound Obstet Gynecol. 2007;30(5):742-9.

Gomez O, Figuerats F, Fernandez S, Bennasar M, Martinez JM, Puerto B et al. Reference ranges for uterine artery mean pulsatality index at 11-41 weeks of gestation. Ultrasound Obstet Gynecol. 2008;32(2):128-32.

Ridding G, Schluter P.J, Hyett J.A, McLennan A.C. Uterine artery pulsatality index assessment at 11- 13+6 weeks gestation. Fetal Diagn Ther. 2014;36(4):299-304.

Poon LCY, Kametas NA Pandeva I, Valencia C, Nicolaides KH. Mean arterial pressure at 110 to 136 weeks in the prediction of preeclampsia. Hypertension. 2008;51(4):1027-33.

Saxena AR, Seely EW, Rich-Edwards, Wilkins-Haug JW, Karumanchi SA, McElrath TF. First trimester PAPP-A levels correlate with sFlt-1 levels longitudinally in pregnant women with and without preeclampsia. BMC Preg and Childbirth. 2013;13(1):85.

Schneuer FJ, Nassar N, Guilbert C, Tasevski V, Ashton AW, Morris JM, et al. First trimester screening of serum soluble fms-like tyrosine kinase-1 and placental growth factor predicting hypertensive disorders of pregnancy. Pregnancy Hypertension: An Int J Women’s Cardio Health. 2013;3(4):215-21.

Jones WK. Improving Women’s Health: National Strategy is needed. Chronic Disease Notes & Reports. National Center for Disease Prevention and Health Promotion. 2000;13:1-7.

Mathews TJ, Curtin SC, MacDorman MF. Infant mortality statistics from the 1998 period linked birth/infant death data set. National Vital Statistics Reports. Hyattsville, Maryland: National Center for Health Statistics. 2000;48(12):1-28.

Yliniemi A, Makikallio K, Korpimaki T, Kouru H, Marttala J, Ryynanen M. Combination of PAPPA, fhCGβ, AFP, PlGF, sTNFR1, and Maternal Characteristics in Prediction of Early-onset Preeclampsia. Clinical Medicine Insights: Repro Health. 2015;9:13-20.

Sung KU, Roh JA, Eoh KJ, Kim EH. Maternal serum placental growth factor and pregnancyassociated plasma protein A measured in the first trimester as parameters of subsequent pre-eclampsia and small-forgestational-age infants: A prospective observational study Obstet Gynecol Sci. 2017;60(2):154-62.

Leona C, Poon, Kypros H. Nicolaides First-trimester maternal factors and biomarker screening for preeclampsia Prenatal Diagnosis. 2014;34(7):618-27.

Duhig KT, Myers JE, Gale C, Girling JC, Harding K, Sharp A, et al. Placental growth factor measurements in the assessment of women with suspected Preeclampsia Pregnancy Hypertension: An Int J Women’s Cardiovascular Health. 2021;23:41-7.

Antwi E, Klipstein-Grobusch K, Browne JL, Schielen PC, Koram KC, Agyepong IA, et al. Improved prediction of gestational hypertension by inclusion of placental growth factor and pregnancy associated plasma protein-a in a sample of Ghanaian women Reproductive Health. 2018;15(1):56.

Wright D, Akolekar R, Syngelaki A, Poon LC, Nicolaides KH. A competing risks model in early screening for preeclampsia. Fetal Diagn Ther. 2012;32(3):171-8.

Mazer Zumaeta A, Wright A, Syngelaki VA, Maritsa AB, Da Silva, Nicolaides KH. Screening for pre-eclampsia at 11–13 weeks’ gestation: use of pregnancy-associated plasma protein-A, placental growth factor or both Ultrasound Obstet Gynecol. 2020;56(3)400-7.

Rolnik DL, Wright D, Poon LC, Gorman N, Syngelaki A, Matallana CP et al. Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia. ASPRE trial. N Engl J Med. 2017;377(7):613:22.

Downloads

Published

2021-04-23

Issue

Section

Original Research Articles