PDF(Pubmed)
Abstract：
BACKGROUND: To assess the rate of change in soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PlGF) ratio and PlGF levels per week compared to a single sFlt-1/PlGF ratio or PlGF level to predict preterm birth for pregnancies complicated by fetal growth restriction.
METHODS: A prospective cohort study of pregnancies complicated by isolated fetal growth restriction. Maternal serum PlGF levels and the sFlt-1/PlGF ratio were measured at 4-weekly intervals from recruitment to delivery. We investigated the utility of PlGF levels, sFlt-1/PlGF ratio, change in PlGF levels per week or sFlt-1/PlGF ratio per week. Cox-proportional hazard models and Harrell\'s C concordance statistic were used to evaluate the effect of biomarkers on time to preterm birth.
RESULTS: The total study cohort was 158 pregnancies comprising 91 (57.6%) with fetal growth restriction and 67 (42.4%) with appropriate for gestational age controls. In the fetal growth restriction cohort, sFlt-1/PlGF ratio and PlGF levels significantly affected time to preterm birth (Harrell\'s C: 0.85-0.76). The rate of increase per week of the sFlt-1/PlGF ratio (hazard ratio [HR] 3.91, 95% confidence interval [CI]: 1.39-10.99, p = 0.01, Harrell\'s C: 0.74) was positively associated with preterm birth but change in PlGF levels per week was not (HR 0.65, 95% CI: 0.25-1.67, p = 0.37, Harrell\'s C: 0.68).
CONCLUSIONS: Both a high sFlt-1/PlGF ratio and low PlGF levels are predictive of preterm birth in women with fetal growth restriction. Although the rate of increase of the sFlt-1/PlGF ratio predicts preterm birth, it is not superior to either a single elevated sFlt-1/PlGF ratio or low PlGF level.
METHODS: A prospective cohort study of pregnancies complicated by isolated fetal growth restriction. Maternal serum PlGF levels and the sFlt-1/PlGF ratio were measured at 4-weekly intervals from recruitment to delivery. We investigated the utility of PlGF levels, sFlt-1/PlGF ratio, change in PlGF levels per week or sFlt-1/PlGF ratio per week. Cox-proportional hazard models and Harrell\'s C concordance statistic were used to evaluate the effect of biomarkers on time to preterm birth.
RESULTS: The total study cohort was 158 pregnancies comprising 91 (57.6%) with fetal growth restriction and 67 (42.4%) with appropriate for gestational age controls. In the fetal growth restriction cohort, sFlt-1/PlGF ratio and PlGF levels significantly affected time to preterm birth (Harrell\'s C: 0.85-0.76). The rate of increase per week of the sFlt-1/PlGF ratio (hazard ratio [HR] 3.91, 95% confidence interval [CI]: 1.39-10.99, p = 0.01, Harrell\'s C: 0.74) was positively associated with preterm birth but change in PlGF levels per week was not (HR 0.65, 95% CI: 0.25-1.67, p = 0.37, Harrell\'s C: 0.68).
CONCLUSIONS: Both a high sFlt-1/PlGF ratio and low PlGF levels are predictive of preterm birth in women with fetal growth restriction. Although the rate of increase of the sFlt-1/PlGF ratio predicts preterm birth, it is not superior to either a single elevated sFlt-1/PlGF ratio or low PlGF level.
摘要：
背景：为了评估每周可溶性fms样酪氨酸激酶-1/胎盘生长因子（sFlt-1/PlGF）比率和PlGF水平与单一sFlt-1/PlGF比率或PlGF水平的变化率，以预测妊娠并发胎儿生长受限的早产。
方法：一项妊娠合并孤立胎儿生长受限的前瞻性队列研究。从招募到分娩，每隔4周测量母亲血清PlGF水平和sFlt-1/PlGF比率。我们调查了PlGF水平的效用，sFlt-1/PlGF比值,每周PlGF水平或每周sFlt-1/PlGF比率的变化。Cox比例风险模型和Harrell的C一致性统计量用于评估生物标志物对早产时间的影响。
结果：总研究队列为158例妊娠，其中91例（57.6%）胎儿生长受限，67例（42.4%）适合胎龄控制。在胎儿生长受限队列中，sFlt-1/PlGF比值和PlGF水平显著影响早产时间(Harrell'sC:0.85-0.76)。sFlt-1/PlGF比率每周的增长率（风险比[HR]3.91，95％置信区间[CI]：1.39-10.99，p=0.01，Harrell\'sC：0.74）与早产呈正相关，但每周PlGF水平的变化却没有（HR0.65，95％CI：0.25-1.67，p=0.37，Harrell\'sC：0.68）。
结论：高sFlt-1/PlGF比值和低PlGF水平均可预测胎儿生长受限妇女的早产。尽管sFlt-1/PlGF比率的增加速率预测早产，它不优于单一升高的sFlt-1/PlGF比率或低PlGF水平。
方法：一项妊娠合并孤立胎儿生长受限的前瞻性队列研究。从招募到分娩，每隔4周测量母亲血清PlGF水平和sFlt-1/PlGF比率。我们调查了PlGF水平的效用，sFlt-1/PlGF比值,每周PlGF水平或每周sFlt-1/PlGF比率的变化。Cox比例风险模型和Harrell的C一致性统计量用于评估生物标志物对早产时间的影响。
结果：总研究队列为158例妊娠，其中91例（57.6%）胎儿生长受限，67例（42.4%）适合胎龄控制。在胎儿生长受限队列中，sFlt-1/PlGF比值和PlGF水平显著影响早产时间(Harrell'sC:0.85-0.76)。sFlt-1/PlGF比率每周的增长率（风险比[HR]3.91，95％置信区间[CI]：1.39-10.99，p=0.01，Harrell\'sC：0.74）与早产呈正相关，但每周PlGF水平的变化却没有（HR0.65，95％CI：0.25-1.67，p=0.37，Harrell\'sC：0.68）。
结论：高sFlt-1/PlGF比值和低PlGF水平均可预测胎儿生长受限妇女的早产。尽管sFlt-1/PlGF比率的增加速率预测早产，它不优于单一升高的sFlt-1/PlGF比率或低PlGF水平。
