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Placental growth factor measurements in the assessment of women with suspected preeclampsia: a stratified analysis of the PARROT trial

2020 The Authors. Published by Elsevier B.V. on behalf of International Society for the Study of Hypertension in Pregnancy. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). http://creativecommons.org/licenses/by/4.0 ;ISSN: 2210-7789 ;EISSN: 2210-7797 ;DOI: 10.1016/j.preghy.2020.10.005

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  • Title:
    Placental growth factor measurements in the assessment of women with suspected preeclampsia: a stratified analysis of the PARROT trial
  • Author: Duhig, KE ; Myers, JE ; Gale, C ; Girling, JC ; Harding, K ; Sharp, A ; Simpson, NAB ; Tuffnell, D ; Seed, PT ; Shennan, AH ; Chappell, LC
  • Subjects: 1114 Paediatrics and Reproductive Medicine
  • Description: Objective Placental growth factor testing decreases time to recognition of preeclampsia and may reduce severe maternal adverse outcomes. This analysis aims to describe the clinical phenotype of women by PlGF concentration, and to determine the mechanism(s) underpinning the reduction in severe maternal adverse outcomes in the PARROT trial, in order to inform how PlGF testing may be optimally used within clinical management algorithms. Study design This was a planned secondary analysis from the PARROT trial that compared revealed PlGF testing and management guidance with usual care in the assessment of women with suspected preterm preeclampsia. Main outcome measures Maternal and perinatal outcomes following stratification of women by trial group, and measured PlGF concentration. Results 1006 women were included. PlGF < 100 pg/ml identified women with more marked hypertension, increased adverse maternal outcomes and preterm delivery rates, and higher rates of small for gestational age infants. There was a reduction in adverse maternal outcomes in women whose results were revealed when PlGF levels were 12–100 pg/ml compared to usual care (3.8% vs 6.9%; aOR 0.15(95% CI 0.03–0.92). There was no significant difference in gestation at delivery between concealed or revealed groups in any PlGF categories. Conclusion Low PlGF concentrations are associated with severe preeclampsia. The reduction in severe adverse maternal outcomes may be mediated through quicker diagnosis and intensive surveillance, as recommended by the management algorithm for those at increased risk. PlGF is particularly beneficial in those who test 12–100 pg/ml, as these may be women with silent multi-organ disease who otherwise may go undetected.
  • Publisher: Elsevier BV
  • Creation Date: 2020-10
  • Language: English
  • Identifier: ISSN: 2210-7789
    EISSN: 2210-7797
    DOI: 10.1016/j.preghy.2020.10.005
  • Source: Spiral
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