title: Predicting delivery of a small-for-gestational-age infant and adverse perinatal outcome in women with suspected pre-eclampsia.
abstract: OBJECTIVE
  To evaluate the test performance of 47 biomarkers and ultrasound parameters for the prediction of delivery of a small-for-gestational-age (SGA) infant and adverse perinatal outcome in women presenting with suspected pre-eclampsia.
  
  
  METHODS
  This was a prospective, multicenter observational study in which 47 biomarkers and ultrasound parameters were measured in 397 women with a singleton pregnancy presenting with suspected preterm pre-eclampsia between 20 + 0 and 36 + 6 weeks' gestation, with the objective of evaluating them as predictors of subsequent delivery of a SGA infant and adverse perinatal outcome. Women with confirmed pre-eclampsia at enrollment were excluded. Factor analysis and stepwise logistic regression were performed in two prespecified groups stratified according to gestational age at enrollment. The primary outcome was delivery of a SGA infant with a birth weight < 3rdcustomized centile (SGA-3), and secondary outcomes were a SGA infant with a birth weight < 10thcustomized centile and adverse perinatal outcome.
  
  
  RESULTS
  In 274 women presenting at 20 + 0 to 34 + 6 weeks' gestation, 96 (35%) delivered a SGA-3 infant. For prediction of SGA-3, low maternal placental growth factor (PlGF) concentration had a sensitivity of 93% (95% CI, 84-98%) and negative predictive value (NPV) of 90% (95% CI, 76-97%) compared with a sensitivity of 71% (95% CI, 58-82%) and a NPV of 79% (95% CI, 68-87%) for ultrasound parameters (estimated fetal weight or abdominal circumference < 10thcentile). No individual biomarker evaluated had a better performance than did PlGF, and marker combinations made only small improvements to the test performance. Similar results were found in 123 women presenting between 35 + 0 and 36 + 6 weeks' gestation.
  
  
  CONCLUSIONS
  In women presenting with suspected preterm pre-eclampsia, measurement of PlGF offers a useful adjunct for identifying those at high risk of delivering a SGA infant, allowing appropriate surveillance and timely intervention. © 2017 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
authors.affiliation: Women's Health Academic Centre, King's College London, London, UK.
authors.forename: M
authors.identifier: http://orcid.org/0000-0002-5448-9513
authors.initials: M
authors.lastname: Griffin
authors.affiliation: Women's Health Academic Centre, King's College London, London, UK.
authors.forename: P T
authors.initials: PT
authors.lastname: Seed
authors.affiliation: Women's Health Academic Centre, King's College London, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Duckworth
authors.affiliation: Women's Health Academic Centre, King's College London, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: North
authors.affiliation: Maternal and Fetal Health Research Centre, University of Manchester, Manchester, UK.
authors.forename: J
authors.initials: J
authors.lastname: Myers
authors.affiliation: Oxford University Hospital NHS Trust, Oxford, UK.
authors.forename: L
authors.initials: L
authors.lastname: Mackillop
authors.affiliation: Division of Women's and Children's Health, Faculty of Health, University of Leeds, Leeds, UK.
authors.forename: N
authors.initials: N
authors.lastname: Simpson
authors.affiliation: Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.
authors.forename: J
authors.initials: J
authors.lastname: Waugh
authors.affiliation: Academic Unit of Reproductive and Developmental Medicine, University of Sheffield, Sheffield, UK.
authors.forename: D
authors.initials: D
authors.lastname: Anumba
authors.affiliation: INFANT Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland.
authors.forename: L C
authors.initials: LC
authors.lastname: Kenny
authors.affiliation: Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK.
authors.forename: C W G
authors.initials: CWG
authors.lastname: Redman
authors.affiliation: Women's Health Academic Centre, King's College London, London, UK.
authors.forename: A H
authors.initials: AH
authors.lastname: Shennan
authors.affiliation: Women's Health Academic Centre, King's College London, London, UK.
authors.forename: L C
authors.identifier: http://orcid.org/0000-0001-6219-3379
authors.initials: LC
authors.lastname: Chappell
mesh_terms: D000328:Adult; D001724:Birth Weight; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D020567:Fetal Weight; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011225:Pre-Eclampsia / Q000097:blood / Q000503:physiopathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011257:Pregnancy Proteins / Q000097:blood*; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal
chemical_list: D011257:Pregnancy Proteins
keywords: growth restriction; placental growth factor; pre-eclampsia; small-for-gestational-age