The relationship between maternal placental growth factor levels and intrapartum fetal compromise

Bligh, Larissa N., Greer, Ristan M. and Kumar, Sailesh (2016) The relationship between maternal placental growth factor levels and intrapartum fetal compromise. Placenta, 48 63-67. doi:10.1016/j.placenta.2016.10.007

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Author Bligh, Larissa N.
Greer, Ristan M.
Kumar, Sailesh
Title The relationship between maternal placental growth factor levels and intrapartum fetal compromise
Journal name Placenta   Check publisher's open access policy
ISSN 0143-4004
1532-3102
Publication date 2016-12-01
Year available 2016
Sub-type Article (original research)
DOI 10.1016/j.placenta.2016.10.007
Open Access Status File (Author Post-print)
Volume 48
Start page 63
End page 67
Total pages 5
Place of publication London, United Kingdom
Publisher Elsevier
Language eng
Subject 2743 Reproductive Medicine
2729 Obstetrics and Gynaecology
1309 Developmental Biology
Abstract Introduction Whilst some cases of intrapartum fetal compromise are the result of unpredictable catastrophic events, the majority arise from an unrecognised reduction in feto-placental reserve in otherwise healthy pregnancies. There is currently no reliable technique prior to labour that identifies the at-risk fetus. We aimed to investigate the relationship between maternal levels of serum placental growth factor (PlGF) and intrapartum fetal compromise in term pregnancies prior to labour. Secondary outcomes were caesarean delivery for intrapartum fetal compromise and adverse neonatal outcomes. Methods A blinded, prospective, cross sectional study set at Mater Mother's Hospital, Brisbane, Australia. Maternal PlGF concentration was assessed fortnightly from 36 weeks until delivery in 378 low-risk pregnant women. Antenatal and intrapartum care was managed according to local protocols and guidelines, and intrapartum and neonatal outcomes were recorded. Results Pregnancies that developed intrapartum fetal compromise had lower PlGF than those that did not. PlGF concentration was also lower amongst pregnancies that developed intrapartum fetal heart rate abnormalities, were delivered with abnormal cord gases or Apgar ≤7 at 5 min. Additionally, PlGF levels were lower in pregnancies with an adverse composite neonatal outcome. Discussion Lower maternal PlGF concentration is associated with intrapartum fetal compromise and poorer condition of the newborn. Maternal PlGF levels may be useful as a component of a risk stratification tool for intrapartum fetal compromise in apparently 'low risk' term pregnancies prior to labour.
Formatted abstract
Introduction: Whilst some cases of intrapartum fetal compromise are the result of unpredictable catastrophic events, the majority arise from an unrecognised reduction in feto-placental reserve in otherwise healthy pregnancies. There is currently no reliable technique prior to labour that identifies the at-risk fetus. We aimed to investigate the relationship between maternal levels of serum placental growth factor (PlGF) and intrapartum fetal compromise in term pregnancies prior to labour. Secondary outcomes were caesarean delivery for intrapartum fetal compromise and adverse neonatal outcomes.

Methods: A blinded, prospective, cross sectional study set at Mater Mother's Hospital, Brisbane, Australia. Maternal PlGF concentration was assessed fortnightly from 36 weeks until delivery in 378 low-risk pregnant women. Antenatal and intrapartum care was managed according to local protocols and guidelines, and intrapartum and neonatal outcomes were recorded.

Results: Pregnancies that developed intrapartum fetal compromise had lower PlGF than those that did not. PlGF concentration was also lower amongst pregnancies that developed intrapartum fetal heart rate abnormalities, were delivered with abnormal cord gases or Apgar ≤7 at 5 min. Additionally, PlGF levels were lower in pregnancies with an adverse composite neonatal outcome.

Discussion: Lower maternal PlGF concentration is associated with intrapartum fetal compromise and poorer condition of the newborn. Maternal PlGF levels may be useful as a component of a risk stratification tool for intrapartum fetal compromise in apparently 'low risk' term pregnancies prior to labour.
Keyword Fetal compromise
Fetal distress
Labor
Placental growth factor
Placental insufficiency
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
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Created: Fri, 04 Nov 2016, 19:09:54 EST by Sailesh Kumar on behalf of Mater Clinical Unit