Decreased maternal serum placenta growth factor in early second trimester and preeclampsia

Objective: To compare early second-trimester maternal serum placenta growth factor concentrations in patients with subsequent development of preeclamp sia and those with normal pregnancies. Methods: We conducted a case-control analysis of stored maternal serum of 2 7 women who subsequently developed preeclampsia and 227 randomly selected n ormal controls during the gestational period of 14-19 weeks. Using such a s ample size, there was a greater than 95% power to test a difference in the primary study interest. A quantitative sandwich enzyme immunoassay was used to measure the maternal serum placenta growth factor concentration. For st atistical analysis, Mann-Whitney U tests, multiple linear regression analys is, multivariable logistic regression model, and receiver-operating charact eristic (ROC) curve were used. P < .05 was considered statistically signifi cant. Results: Maternal serum placenta growth factor concentration was associated with the occurrence of subsequent preeclampsia (P < .001) and gestational age (P < .001). The median (interquartile range) of multiples (MoM) of the gestational age stratified median for placenta growth factor in preeclampsi a was 0.55 (0.33, 0.85). The ROC curve revealed that the specificity was 70 % when the diagnostic sensitivity was 70%, and the optimal cutoff value of placenta growth factor MoM was 0.76. The risk of developing preeclampsia su bsequently was increased 2.5-fold for maternal serum placenta growth factor concentration decrements of 0.1 MoM. Conclusion: A decreased maternal serum placenta growth factor concentration in the early second trimester is highly associated with the subsequent dev elopment of preeclampsia, but a large prospective study is needed to explor e its use as an early predictor for the condition. (Obstet Gynecol 2001;97: 898-904. (C) 2001 by The American College of Obstetricians and Gynecologist s.).