title: Longitudinal evaluation of predictive value for preeclampsia of circulating angiogenic factors through pregnancy.
abstract: OBJECTIVE
  The purpose of this study was to examine whether longitudinally sampled maternal angiogenic concentrations predict preeclampsia.
  
  
  METHODS
  Plasma sFlt-1 and placental growth factor (PlGF) concentrations in healthy pregnant women were quantified at 10, 17, 25, and 35 weeks' gestation. Preeclampsia was diagnosed with criteria from the American College of Obstetricians and Gynecologists.
  
  
  RESULTS
  In the first trimester, sensitivity/specificity for PlGF and sFlt-1 were 55/43% and 57/40%, respectively, and did not improve appreciably as the pregnancy progressed. Among pregnancies that later experienced preeclampsia, median PlGF was lower beginning in the second trimester, but sFlt-1 was not higher until the third trimester. Analyte positive predictive values approached 10% in the third trimester. Negative predictive values were >90% for the entire pregnancy.
  
  
  CONCLUSIONS
  Prediction of preeclampsia in early pregnancy was not possible with the use of maternal angiogenic protein concentrations. Even in late pregnancy, positive predictive values were not useful clinically. Negative predictive values are similarly unlikely to prove useful as a tool with which to a rule out suspected disease.
authors.affiliation: Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: McElrath
authors.forename: Kee-Hak
authors.initials: KH
authors.lastname: Lim
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Pare
authors.forename: Janet
authors.initials: J
authors.lastname: Rich-Edwards
authors.forename: Dominick
authors.initials: D
authors.lastname: Pucci
authors.forename: Rebecca
authors.initials: R
authors.lastname: Troisi
authors.forename: Samuel
authors.initials: S
authors.lastname: Parry
mesh_terms: D000293:Adolescent; D000328:Adult; D043925:Angiogenesis Inducing Agents / Q000097:blood*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008565:Membrane Proteins / Q000097:blood; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011262:Pregnancy Trimester, Second / Q000097:blood; D011263:Pregnancy Trimester, Third / Q000097:blood; D012680:Sensitivity and Specificity; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood; D055815:Young Adult
chemical_list: D043925:Angiogenesis Inducing Agents; D008565:Membrane Proteins; C098069:PIGF protein, human; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1