title: Is serum placental growth factor more effective as a biomarker in predicting early onset preeclampsia in early second trimester than in first trimester of pregnancy?
abstract: OBJECTIVE
  To determine whether maternal serum placental growth factor (PlGF) is more effective as a biomarker in predicting the occurrence of early onset preeclampsia in first trimester or early second trimester of pregnancy.
  
  
  METHODS
  A prospective cohort study was conducted on women with singleton pregnancies, screened from the antenatal clinic. Serum PlGF estimation was done at 11-14 weeks of gestation on 1,244 women and at 22-24 weeks of gestation on 1,206 women from the initial study population. A cut-off value of <228 pg/ml for serum PlGF at 11-14 weeks of gestation and <144 pg/ml for serum PlGF at 22-24 weeks of gestation were determined by receiver operating characteristic (ROC) curve analysis for identifying pregnant women at risk of developing early onset preeclampsia (<32 weeks of gestation). Univariate logistic regression analysis was used to analyze the association between serum PlGF < 228 pg/ml at 11-14 weeks of gestation and <144 pg/ml at 22-24 weeks of gestation with the occurrence of early onset preeclampsia and odds ratio (OR) was computed. P value < 0.05 was considered statistically significant in this study.
  
  
  RESULTS
  Maternal serum PlGF <144 pg/ml at 22-24 weeks of gestation had a stronger association (OR 18.83; 95 % CI 12.08-22.24; p = 0.000) than serum PlGF <228 pg/ml at 11-14 weeks of gestation (OR 2.76; 95 % CI 1.29-3.94; p = 0.007) with the occurrence of early onset preeclampsia. The sensitivity and specificity of serum PlGF <144 pg/ml at 22-24 weeks of gestation (84 and 78, respectively) were much higher than those of serum PlGF <228 pg/ml at 11-14 weeks of gestation (58 and 66, respectively) in predicting early onset preeclampsia.
  
  
  CONCLUSIONS
  Maternal serum PlGF may be more effective as a biomarker in early second trimester than in first trimester of pregnancy, in predicting the occurrence of early onset preeclampsia.
authors.affiliation: Department of Anatomy, Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital, Room No. 118, House Surgeons Block, Shaheed Bhagat Singh Marg, New Delhi, 110001, India. drsanjib79@gmail.com
authors.forename: Sanjib Kumar
authors.initials: SK
authors.lastname: Ghosh
authors.forename: Shashi
authors.initials: S
authors.lastname: Raheja
authors.forename: Anita
authors.initials: A
authors.lastname: Tuli
authors.forename: Chitra
authors.initials: C
authors.lastname: Raghunandan
authors.forename: Sneh
authors.initials: S
authors.lastname: Agarwal
mesh_terms: D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D016015:Logistic Models; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood*; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor