Journal article
Utility of placental biomarkers and fetoplacental Dopplers in predicting likely placental pathology in early and late fetal growth restriction – A prospective study
Placenta , Vol.156, pp.20-29
2024
Abstract
Introduction
The aim of this study was to evaluate the association between placental abnormalities, placental biomarkers, and fetoplacental Dopplers in a cohort of pregnancies complicated by fetal growth restriction (FGR). We also ascertained the risk of perinatal mortality, severe neurological morbidity, and severe non-neurological morbidity by type of placental abnormality.
Methods
This was a prospective cohort study. Multivariable logistic regression was used to evaluate the effect of early vs. late FGR, placental biomarkers and fetoplacental Dopplers on Maternal Vascular Malperfusion (MVM) which was the commonest placental abnormality identified.
Results
There were 161 (53.5 %) early FGR and 140 (46.5 %) late FGR cases. MVM abnormalities were present in 154 (51.2 %), VUE in 45 (14.6 %), FVM in 16 (5.3 %), DVM in 14 (4.7 %) and CHI in 4 (1.3 %) cases. The odds of MVM were higher in early compared to late FGR cohort (OR 1.89, 95%CI 1.14, 3.14, p = 0.01). Low maternal PlGF levels <100 ng/L (OR 2.34, 95%CI 1.27,4.31, p = 0.01), high sFlt-1 level (OR 2.13, 95%CI 1.35, 3.36, p = 0.001) or elevated sFlt-1/PlGF ratio (OR 3.48, 95%CI 1.36, 8.91, p = 0.01) were all associated with MVM. Increased UA PI > 95th centile (OR 2.91, 95%CI 1.71, 4.95, p=<0.001) and mean UtA PI z-score (OR 1.74, 95%CI 1.15, 2.64, p = 0.01) were associated with higher odds of MVM. Rates of severe non-neurological morbidity were highest in the MVM, FVM, and CHI cohorts (44.8 %, 50 %, and 50 % respectively).
Conclusion
MVM was the commonest placental abnormality in FGR, particularly in early-onset disease. Low maternal PlGF levels, high sFlt-1 levels, elevated sFlt-1/PlGF ratio, and abnormal fetoplacental Dopplers were also significantly associated with MVM. MVM, FVM, and CHI abnormalities were associated with lower median birthweight, higher rates of preterm birth, operative birth for non-reassuring fetal status, and severe neonatal non-neurological morbidity.
Details
- Title
- Utility of placental biomarkers and fetoplacental Dopplers in predicting likely placental pathology in early and late fetal growth restriction – A prospective study
- Authors
- Jesrine Hong (Author) - Mater ResearchKylie Crawford (Author) - Mater ResearchMatthew Daly (Author) - University of QueenslandVicki Clifton (Author) - University of QueenslandFabricio da Silva Costa (Author) - Gold Coast HospitalAnthony V. Perkins (Author) - University of the Sunshine Coast, Queensland, School of HealthAdmire Matsika (Author) - Mater ResearchRohan Lourie (Author) - University of QueenslandSailesh Kumar (Corresponding Author) - Mater Research
- Publication details
- Placenta , Vol.156, pp.20-29
- Publisher
- Elsevier Ltd
- Date published
- 2024
- DOI
- 10.1016/j.placenta.2024.08.016
- ISSN
- 1532-3102
- Data Availability
- Data used to produce the results in this article will be available to any researcher provided appropriate ethics approval, inter-institutional data sharing agreements and other regulatory requirements are in place.
- Grant note
- National Health and Medical Research Council and Mater Foundation.
- Organisation Unit
- School of Health
- Language
- English
- Record Identifier
- 991062294402621
- Output Type
- Journal article
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- Domestic collaboration
- International collaboration
- Web Of Science research areas
- Developmental Biology
- Obstetrics & Gynecology
- Reproductive Biology
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