title: Diagnostic Performance of Placental Growth Factor in Women With Suspected Preeclampsia Attending Antenatal Facilities in Maputo, Mozambique.
abstract: In well-resourced settings, reduced circulating maternal-free placental growth factor (PlGF) aids in either predicting or confirming the diagnosis of preeclampsia, fetal growth restriction, stillbirth, preterm birth, and delivery within 14 days of testing when preeclampsia is suspected. This blinded, prospective cohort study of maternal plasma PlGF in women with suspected preeclampsia was conducted in antenatal clinics in Maputo, Mozambique. The primary outcome was the clinic-to-delivery interval. Other outcomes included: confirmed diagnosis of preeclampsia, transfer to higher care, mode of delivery, intrauterine fetal death, preterm birth, and low birth weight. Of 696 women, 95 (13.6%) and 601 (86.4%) women had either low (<100 pg/mL) or normal (≥100 pg/mL) plasma PlGF, respectively. The clinic-to-delivery interval was shorter in low PlGF, compared with normal PlGF, women (median 24 days [interquartile range, 10-49] versus 44 [24-81],P=0.0042). Also, low PlGF was associated with a confirmed diagnosis of preeclampsia, higher blood pressure, transfer for higher care, earlier gestational age delivery, delivery within 7 and 14 days, preterm birth, cesarean delivery, lower birth weight, and perinatal loss. In urban Mozambican women with symptoms or signs suggestive of preeclampsia, low maternal plasma PlGF concentrations are associated with increased risks of adverse pregnancy outcomes, whether the diagnosis of preeclampsia is confirmed. Therefore, PlGF should improve the provision of precision medicine to individual women and improve pregnancy outcomes for those with preeclampsia or related placenta-mediated complications.
authors.affiliation: From the Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada (U.V.U., S.D.); National Department of Public Health, Ministry of Health, Maputo, Mozambique (F.M.); Maternal, Newborn, + Child Health, Clinton Health Access Initiative, Maputo, Mozambique (B.M.R., C.M.); Faculty of Sciences, Mathematics and Informatics Department, Eduardo Mondlane University, Maputo, Mozambique (O.L.); Department of Obstetrics and Gynaecology, Hospital Geral José Macamo, Maputo, Mozambique (M.U.); PMTCT Technical Program, Centre for Collaboration in Health (CCS), Maputo, Mozambique (M.U.); Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St. George's, University of London, United Kingdom (L.A.M., P.v.D.); and Department of Obstetrics and Gynaecology, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom (L.A.M., P.v.D.).
authors.forename: U Vivian
authors.initials: UV
authors.lastname: Ukah
authors.affiliation: From the Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada (U.V.U., S.D.); National Department of Public Health, Ministry of Health, Maputo, Mozambique (F.M.); Maternal, Newborn, + Child Health, Clinton Health Access Initiative, Maputo, Mozambique (B.M.R., C.M.); Faculty of Sciences, Mathematics and Informatics Department, Eduardo Mondlane University, Maputo, Mozambique (O.L.); Department of Obstetrics and Gynaecology, Hospital Geral José Macamo, Maputo, Mozambique (M.U.); PMTCT Technical Program, Centre for Collaboration in Health (CCS), Maputo, Mozambique (M.U.); Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St. George's, University of London, United Kingdom (L.A.M., P.v.D.); and Department of Obstetrics and Gynaecology, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom (L.A.M., P.v.D.).
authors.forename: Francisco
authors.initials: F
authors.lastname: Mbofana
authors.affiliation: From the Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada (U.V.U., S.D.); National Department of Public Health, Ministry of Health, Maputo, Mozambique (F.M.); Maternal, Newborn, + Child Health, Clinton Health Access Initiative, Maputo, Mozambique (B.M.R., C.M.); Faculty of Sciences, Mathematics and Informatics Department, Eduardo Mondlane University, Maputo, Mozambique (O.L.); Department of Obstetrics and Gynaecology, Hospital Geral José Macamo, Maputo, Mozambique (M.U.); PMTCT Technical Program, Centre for Collaboration in Health (CCS), Maputo, Mozambique (M.U.); Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St. George's, University of London, United Kingdom (L.A.M., P.v.D.); and Department of Obstetrics and Gynaecology, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom (L.A.M., P.v.D.).
authors.forename: Beatriz Manriquez
authors.initials: BM
authors.lastname: Rocha
authors.affiliation: From the Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada (U.V.U., S.D.); National Department of Public Health, Ministry of Health, Maputo, Mozambique (F.M.); Maternal, Newborn, + Child Health, Clinton Health Access Initiative, Maputo, Mozambique (B.M.R., C.M.); Faculty of Sciences, Mathematics and Informatics Department, Eduardo Mondlane University, Maputo, Mozambique (O.L.); Department of Obstetrics and Gynaecology, Hospital Geral José Macamo, Maputo, Mozambique (M.U.); PMTCT Technical Program, Centre for Collaboration in Health (CCS), Maputo, Mozambique (M.U.); Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St. George's, University of London, United Kingdom (L.A.M., P.v.D.); and Department of Obstetrics and Gynaecology, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom (L.A.M., P.v.D.).
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Loquiha
authors.affiliation: From the Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada (U.V.U., S.D.); National Department of Public Health, Ministry of Health, Maputo, Mozambique (F.M.); Maternal, Newborn, + Child Health, Clinton Health Access Initiative, Maputo, Mozambique (B.M.R., C.M.); Faculty of Sciences, Mathematics and Informatics Department, Eduardo Mondlane University, Maputo, Mozambique (O.L.); Department of Obstetrics and Gynaecology, Hospital Geral José Macamo, Maputo, Mozambique (M.U.); PMTCT Technical Program, Centre for Collaboration in Health (CCS), Maputo, Mozambique (M.U.); Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St. George's, University of London, United Kingdom (L.A.M., P.v.D.); and Department of Obstetrics and Gynaecology, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom (L.A.M., P.v.D.).
authors.forename: Chishamiso
authors.initials: C
authors.lastname: Mudenyanga
authors.affiliation: From the Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada (U.V.U., S.D.); National Department of Public Health, Ministry of Health, Maputo, Mozambique (F.M.); Maternal, Newborn, + Child Health, Clinton Health Access Initiative, Maputo, Mozambique (B.M.R., C.M.); Faculty of Sciences, Mathematics and Informatics Department, Eduardo Mondlane University, Maputo, Mozambique (O.L.); Department of Obstetrics and Gynaecology, Hospital Geral José Macamo, Maputo, Mozambique (M.U.); PMTCT Technical Program, Centre for Collaboration in Health (CCS), Maputo, Mozambique (M.U.); Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St. George's, University of London, United Kingdom (L.A.M., P.v.D.); and Department of Obstetrics and Gynaecology, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom (L.A.M., P.v.D.).
authors.forename: Momade
authors.initials: M
authors.lastname: Usta
authors.affiliation: From the Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada (U.V.U., S.D.); National Department of Public Health, Ministry of Health, Maputo, Mozambique (F.M.); Maternal, Newborn, + Child Health, Clinton Health Access Initiative, Maputo, Mozambique (B.M.R., C.M.); Faculty of Sciences, Mathematics and Informatics Department, Eduardo Mondlane University, Maputo, Mozambique (O.L.); Department of Obstetrics and Gynaecology, Hospital Geral José Macamo, Maputo, Mozambique (M.U.); PMTCT Technical Program, Centre for Collaboration in Health (CCS), Maputo, Mozambique (M.U.); Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St. George's, University of London, United Kingdom (L.A.M., P.v.D.); and Department of Obstetrics and Gynaecology, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom (L.A.M., P.v.D.).
authors.forename: Marilena
authors.initials: M
authors.lastname: Urso
authors.affiliation: From the Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada (U.V.U., S.D.); National Department of Public Health, Ministry of Health, Maputo, Mozambique (F.M.); Maternal, Newborn, + Child Health, Clinton Health Access Initiative, Maputo, Mozambique (B.M.R., C.M.); Faculty of Sciences, Mathematics and Informatics Department, Eduardo Mondlane University, Maputo, Mozambique (O.L.); Department of Obstetrics and Gynaecology, Hospital Geral José Macamo, Maputo, Mozambique (M.U.); PMTCT Technical Program, Centre for Collaboration in Health (CCS), Maputo, Mozambique (M.U.); Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St. George's, University of London, United Kingdom (L.A.M., P.v.D.); and Department of Obstetrics and Gynaecology, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom (L.A.M., P.v.D.).
authors.forename: Sharla
authors.initials: S
authors.lastname: Drebit
authors.affiliation: From the Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada (U.V.U., S.D.); National Department of Public Health, Ministry of Health, Maputo, Mozambique (F.M.); Maternal, Newborn, + Child Health, Clinton Health Access Initiative, Maputo, Mozambique (B.M.R., C.M.); Faculty of Sciences, Mathematics and Informatics Department, Eduardo Mondlane University, Maputo, Mozambique (O.L.); Department of Obstetrics and Gynaecology, Hospital Geral José Macamo, Maputo, Mozambique (M.U.); PMTCT Technical Program, Centre for Collaboration in Health (CCS), Maputo, Mozambique (M.U.); Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St. George's, University of London, United Kingdom (L.A.M., P.v.D.); and Department of Obstetrics and Gynaecology, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom (L.A.M., P.v.D.).
authors.forename: Laura A
authors.initials: LA
authors.lastname: Magee
authors.affiliation: From the Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada (U.V.U., S.D.); National Department of Public Health, Ministry of Health, Maputo, Mozambique (F.M.); Maternal, Newborn, + Child Health, Clinton Health Access Initiative, Maputo, Mozambique (B.M.R., C.M.); Faculty of Sciences, Mathematics and Informatics Department, Eduardo Mondlane University, Maputo, Mozambique (O.L.); Department of Obstetrics and Gynaecology, Hospital Geral José Macamo, Maputo, Mozambique (M.U.); PMTCT Technical Program, Centre for Collaboration in Health (CCS), Maputo, Mozambique (M.U.); Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St. George's, University of London, United Kingdom (L.A.M., P.v.D.); and Department of Obstetrics and Gynaecology, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom (L.A.M., P.v.D.). pvd@sgul.ac.uk.
authors.forename: Peter
authors.initials: P
authors.lastname: von Dadelszen
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D009073:Mozambique / Q000453:epidemiology; D000072483:Placenta Growth Factor / Q000097:blood*; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
chemical_list: D000072483:Placenta Growth Factor
keywords: birth weight; blood pressure; fetal death; pre-eclampsia; pregnancy