PREDICTION OF THE SEVERITY OF PREECLAMPSIA BASED ON URINARY PLACENTAL GROWTH FACTOR CONCENTRATIONS IN THE FIRST TRIMESTER OF PREGNANCY: A PROSPECTIVE COHORT STUDY
Objective: assessment of prediction of the severity of preeclampsia (PE) based on the concentration of placental growth factor (PLGF) in urine in comparison with the concentrations of PLGF in the blood, determined in the first trimester of pregnancy.
Materials and methods: it was a single-center prospective cohort study, included 288 pregnant women without risk factors of PE, selected by a simple random sample. All subjects underwent general clinical examination and assessment of previous health events. Diagnosis of PE and assessment of its severity were carried out according to the criteria of the International Society for the Study of Hypertension in Pregnancy. PLGF levels in blood and urine were determined at a gestational age of 10-14 weeks by ELISA by the Dialab ELX808IU analyzer (Dialab, Austria) using Human Placental Growth Factor ELISA Kit reagents (Sigma Aldrich, Germany).
Results: There were 2.4% (n = 7) mild PE, 2.8% (n = 8) severe PE, and 94.8% (n = 273) of patients were normotensive during pregnancy. The concentrations of urinary PLGF were 7.97 (6.35-27.21) pg/ml in mild PE and was not statistically different fr om normotensive patients, wh ere the level of urinary PLGF was 21.4 (14.3-35.1) pg/ml, as well as with the level of serum PLGF with mild PE (p> 0.05). In severe PE, urinary PLGF concentrations were 7.17 (5.24-16.2) pg/ml and were statistically lower in comparison with normotensive pregnant women (p < 0.05) and with serum PLGF (p = 0.0233). ROC-analysis showed optimal cut-off levels in severe PE for urinary PLGF ≤ 10.8 pg/ml, with diagnostic indicators AUC 0.869, p <0.0001, Se 71.4%, Sp 87.2%, DOR 16.8.
Conclusions: determination of urinary PLGF in the first trimester of pregnancy may be used to prediction of severe PE, but not for mild PE, and may be used to develop express test systems. The limitations of this study warrant further study of urinary PLGF to predict PE and its severity.
Andrei N. Gaidai1, Akylbek B. Tusupkaliev1,
Sagira S. Zhumagulova1, Nazerke E. Kasaeva1
1 West Kazakhstan Medical University named after Marat Ospanov,
Aktobe c., Republic of Kazakhstan.
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Gaidai A.N., Tusupkaliev A.B., Zhumagulova S.S., Kasaeva N.E. Prediction of the severity of preeclampsia based on urinary placental growth factor concentrations in the first trimester of pregnancy: a prospective cohort study // Nauka i Zdravookhranenie [Science & Healthcare]. 2021, (Vol.23) 6, pp. 54-62. doi 10.34689/SH.2021.23.6.006Related publications:
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