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Diagnostic accuracy of placental growth factor and ultrasound parameters to predict the small-for-gestational-age infant in women presenting with reduced symphysis-fundus height.

TitleDiagnostic accuracy of placental growth factor and ultrasound parameters to predict the small-for-gestational-age infant in women presenting with reduced symphysis-fundus height.
Publication TypeJournal Article
Year of Publication2015
AuthorsGriffin, M, Seed, P, Webster, L, Myers, J, MacKillop, L, Simpson, N, Anumba, D, Khalil, A, Denbow, M, Sau, A, Hinshaw, K, von Dadelszen, P, Benton, S, Girling, J, Redman, C, Chappell, L, Shennan, A
JournalUltrasound Obstet Gynecol
Volume46
Issue2
Pagination182-90
Date Published2015 Aug
ISSN1469-0705
KeywordsAdult, Amniotic Fluid, Female, Fetal Growth Retardation, Humans, Infant, Newborn, Infant, Small for Gestational Age, Intercellular Signaling Peptides and Proteins, Placenta Growth Factor, Predictive Value of Tests, Pregnancy, Pregnancy Proteins, Pregnancy Trimester, Third, Pubic Symphysis, Reproducibility of Results, ROC Curve, Ultrasonography, Prenatal, Umbilical Arteries, Uterus
Abstract

OBJECTIVES: To assess the diagnostic accuracy of placental growth factor (PlGF) and ultrasound parameters to predict delivery of a small-for-gestational-age (SGA) infant in women presenting with reduced symphysis-fundus height (SFH).

METHODS: This was a multicenter prospective observational study recruiting 601 women with a singleton pregnancy and reduced SFH between 24 and 37 weeks' gestation across 11 sites in the UK and Canada. Plasma PlGF concentration < 5(th) centile, estimated fetal weight (EFW) < 10(th) centile, umbilical artery Doppler pulsatility index > 95(th) centile and oligohydramnios (amniotic fluid index < 5 cm) were compared as predictors for a SGA infant < 3(rd) customized birth-weight centile and adverse perinatal outcome. Test performance statistics were calculated for all parameters in isolation and in combination.

RESULTS: Of the 601 women recruited, 592 were analyzed. For predicting delivery of SGA < 3(rd) centile (n = 78), EFW < 10(th) centile had 58% sensitivity (95% CI, 46-69%) and 93% negative predictive value (NPV) (95% CI, 90-95%), PlGF had 37% sensitivity (95% CI, 27-49%) and 90% NPV (95% CI, 87-93%); in combination, PlGF and EFW < 10(th) centile had 69% sensitivity (95% CI, 55-81%) and 93% NPV (95% CI, 89-96%). The equivalent receiver-operating characteristics (ROC) curve areas were 0.79 (95% CI, 0.74-0.84) for EFW < 10(th) centile, 0.70 (95% CI, 0.63-0.77) for low PlGF and 0.82 (95% CI, 0.77-0.86) in combination.

CONCLUSIONS: For women presenting with reduced SFH, ultrasound parameters had modest test performance for predicting delivery of SGA < 3(rd) centile. PlGF performed no better than EFW < 10(th) centile in determining delivery of a SGA infant.

DOI10.1002/uog.14860
Alternate JournalUltrasound Obstet Gynecol
Citation Key604
PubMed ID25826778
PubMed Central IDPMC4744762
Grant ListNIHR-CS-011-020 / / Department of Health / United Kingdom
RP-2014-05-019 / / Department of Health / United Kingdom