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Early diagnosis of preeclampsia using placental growth factor: An operational pilot study in Maputo, Mozambique.

TitleEarly diagnosis of preeclampsia using placental growth factor: An operational pilot study in Maputo, Mozambique.
Publication TypeJournal Article
Year of Publication2018
AuthorsRocha, B, Mbofana, F, Loquiha, O, Mudenyanga, C, Ukah, V, Magee, LA, von Dadelszen, P
JournalPregnancy Hypertens
Volume11
Pagination26-31
Date Published2018 Jan
ISSN2210-7797
KeywordsAdult, Area Under Curve, Biomarkers, Blood Pressure, Case-Control Studies, Down-Regulation, Early Diagnosis, Female, Humans, Mozambique, PIERS, Pilot Projects, Placenta Growth Factor, Pre-Eclampsia, Predictive Value of Tests, Pregnancy, Premature Birth, Reproducibility of Results, Risk Factors, ROC Curve, Stillbirth, Urban Health, Young Adult
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 pre-eclampsia is suspected. This operational pilot implementation of maternal plasma PlGF in women with suspected preeclampsia was conducted in six antenatal clinics in Maputo, Mozambique (six control clinics for comparison). The primary outcome was transfer to higher levels of care, following the informative PlGF assay. Of antenatal visits, 133/31,993 (0.42%) and 20/33,841 (0.06%) resulted in pre-eclampsia-related transfers of care for women attending intervention and control clinics, respectively (p < .0001). The clinic-to-delivery for women with low PlGF (<100 pg/ml) interval was shorter, (vs normal PlGF (median 10 days [IQR 1-25] vs 36 [11-83], p < .0001)). Low PlGF was associated with younger maternal age, higher blood pressure, earlier delivery, more therapeutic interventions, preterm birth, lower birth weight, and perinatal loss. In addition, one-third of hypertensive women with PlGF < 50 pg/ml suffered a stillbirth. In urban Mozambican women with symptoms and/or signs suggestive of preeclampsia, low maternal plasma PlGF concentrations are associated with increased risks of adverse pregnancy outcomes, especially early delivery and stillbirth. Therefore, introducing PlGF into the clinical care of women with suspected preeclampsia was associated with increased transfers to higher levels of care; low PlGF (<100 pg/ml) was associated with increased maternal and perinatal risks. PlGF < 50 pg/ml is particularly associated with stillbirth in women with suspected preeclampsia.

DOI10.1016/j.preghy.2017.12.005
Alternate JournalPregnancy Hypertens
Citation Key488
PubMed ID29523269