PDF(Pubmed)
Abstract：
UNASSIGNED: Fetuses with growth abnormalities are at an increased risk of adverse neonatal outcomes. The aim of this study was to investigate if placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), or the sFlt-1/PlGF ratio were efficient predictive factors of adverse neonatal outcomes in small-for-gestational-age (SGA) newborns.
UNASSIGNED: A prospective observational multicenter cohort study was performed between 2020 and 2023. At the time of the SGA fetus diagnosis, serum angiogenic biomarker measurements were performed. The primary outcome was an adverse neonatal outcome, diagnosed in the case of any of the following: <34 weeks of gestation: mechanical ventilation, sepsis, necrotizing enterocolitis, intraventricular hemorrhage grade III or IV, and neonatal death before discharge; ≥34 weeks of gestation: Neonatal Intensive Care Unit hospitalization, mechanical ventilation, continuous positive airway pressure, sepsis, necrotizing enterocolitis, intraventricular hemorrhage grade III or IV, and neonatal death before discharge.
UNASSIGNED: In total, 192 women who delivered SGA newborns were included in the study. The serum concentrations of PlGF were lower, leading to a higher sFlt-1/PlGF ratio in the adverse outcome group. No significant differences in sFlt-1 levels were observed between the groups. Both PlGF and sFlt-1 had a moderate correlation with adverse neonatal outcomes (PlGF: R - 0.5, p < 0.001; sFlt-1: 0.5, p < 0.001). The sFlt-1/PlGF ratio showed a correlation of 0.6 (p < 0.001) with adverse outcomes. The uterine artery pulsatility index (PI) and the sFlt-1/PlGF ratio were identified as the only independent risk factors for adverse outcomes. An sFlt-1/PlGF ratio of 19.1 exhibited high sensitivity (85.1%) but low specificity (35.9%) in predicting adverse outcomes and had the strongest correlation with them. This ratio allowed the risk of adverse outcomes to be assessed as low with approximately 80% certainty.
UNASSIGNED: The sFlt-1/PlGF ratio seems to be an efficient predictive tool in adverse outcome risk assessment. More studies on large cohorts of SGA-complicated pregnancies with and without preeclampsia are needed to develop an optimal and detailed formula for the risk assessment of adverse outcomes in SGA newborns.
UNASSIGNED: A prospective observational multicenter cohort study was performed between 2020 and 2023. At the time of the SGA fetus diagnosis, serum angiogenic biomarker measurements were performed. The primary outcome was an adverse neonatal outcome, diagnosed in the case of any of the following: <34 weeks of gestation: mechanical ventilation, sepsis, necrotizing enterocolitis, intraventricular hemorrhage grade III or IV, and neonatal death before discharge; ≥34 weeks of gestation: Neonatal Intensive Care Unit hospitalization, mechanical ventilation, continuous positive airway pressure, sepsis, necrotizing enterocolitis, intraventricular hemorrhage grade III or IV, and neonatal death before discharge.
UNASSIGNED: In total, 192 women who delivered SGA newborns were included in the study. The serum concentrations of PlGF were lower, leading to a higher sFlt-1/PlGF ratio in the adverse outcome group. No significant differences in sFlt-1 levels were observed between the groups. Both PlGF and sFlt-1 had a moderate correlation with adverse neonatal outcomes (PlGF: R - 0.5, p < 0.001; sFlt-1: 0.5, p < 0.001). The sFlt-1/PlGF ratio showed a correlation of 0.6 (p < 0.001) with adverse outcomes. The uterine artery pulsatility index (PI) and the sFlt-1/PlGF ratio were identified as the only independent risk factors for adverse outcomes. An sFlt-1/PlGF ratio of 19.1 exhibited high sensitivity (85.1%) but low specificity (35.9%) in predicting adverse outcomes and had the strongest correlation with them. This ratio allowed the risk of adverse outcomes to be assessed as low with approximately 80% certainty.
UNASSIGNED: The sFlt-1/PlGF ratio seems to be an efficient predictive tool in adverse outcome risk assessment. More studies on large cohorts of SGA-complicated pregnancies with and without preeclampsia are needed to develop an optimal and detailed formula for the risk assessment of adverse outcomes in SGA newborns.
摘要：
■生长异常的胎儿发生不良新生儿结局的风险增加。这项研究的目的是调查胎盘生长因子(PlGF)可溶性fms样酪氨酸激酶-1（sFlt-1），或sFlt-1/PlGF比值是小于胎龄儿(SGA)新生儿不良新生儿结局的有效预测因素.
■在2020年至2023年之间进行了一项前瞻性观察性多中心队列研究。在SGA胎儿诊断时，进行血清血管生成生物标志物测量.主要结局是不良的新生儿结局，在以下任何情况下诊断：<34孕周：机械通气，脓毒症,坏死性小肠结肠炎,脑室出血III或IV级，出院前和新生儿死亡；妊娠≥34周：新生儿重症监护病房住院，机械通气,持续气道正压通气,脓毒症,坏死性小肠结肠炎,脑室出血III或IV级，和新生儿出院前死亡。
■总共，该研究包括192名分娩SGA新生儿的妇女。PlGF的血清浓度较低，导致不良结局组中sFlt-1/PlGF比率更高。在组间没有观察到sFlt-1水平的显著差异。PlGF和sFlt-1均与新生儿不良结局具有中等相关性(PlGF:R-0.5,p<0.001;sFlt-1:0.5,p<0.001)。sFlt-1/PlGF比值显示与不良结局的相关性为0.6(p<0.001)。子宫动脉搏动指数（PI）和sFlt-1/PlGF比值被确定为不良结局的唯一独立危险因素。19.1的sFlt-1/PlGF比率在预测不良结局方面表现出较高的敏感性（85.1％），但较低的特异性（35.9％），并且与不良结局的相关性最强。该比率允许不良后果的风险被评估为低，具有约80％的确定性。
■sFlt-1/PlGF比率似乎是不良结局风险评估中的有效预测工具。需要对伴有和不伴有先兆子痫的SGA并发妊娠的大型队列进行更多研究，以开发出最佳和详细的公式来评估SGA新生儿的不良后果。
■在2020年至2023年之间进行了一项前瞻性观察性多中心队列研究。在SGA胎儿诊断时，进行血清血管生成生物标志物测量.主要结局是不良的新生儿结局，在以下任何情况下诊断：<34孕周：机械通气，脓毒症,坏死性小肠结肠炎,脑室出血III或IV级，出院前和新生儿死亡；妊娠≥34周：新生儿重症监护病房住院，机械通气,持续气道正压通气,脓毒症,坏死性小肠结肠炎,脑室出血III或IV级，和新生儿出院前死亡。
■总共，该研究包括192名分娩SGA新生儿的妇女。PlGF的血清浓度较低，导致不良结局组中sFlt-1/PlGF比率更高。在组间没有观察到sFlt-1水平的显著差异。PlGF和sFlt-1均与新生儿不良结局具有中等相关性(PlGF:R-0.5,p<0.001;sFlt-1:0.5,p<0.001)。sFlt-1/PlGF比值显示与不良结局的相关性为0.6(p<0.001)。子宫动脉搏动指数（PI）和sFlt-1/PlGF比值被确定为不良结局的唯一独立危险因素。19.1的sFlt-1/PlGF比率在预测不良结局方面表现出较高的敏感性（85.1％），但较低的特异性（35.9％），并且与不良结局的相关性最强。该比率允许不良后果的风险被评估为低，具有约80％的确定性。
■sFlt-1/PlGF比率似乎是不良结局风险评估中的有效预测工具。需要对伴有和不伴有先兆子痫的SGA并发妊娠的大型队列进行更多研究，以开发出最佳和详细的公式来评估SGA新生儿的不良后果。
