Utility of Placental Growth Factor for the Prediction of Miscarriage in the First Trimester of Pregnancy: A Case-Control Study.

OBJECTIVE

About 26% of all pregnancies result in miscarriage, with up to 10% occurring in clinically diagnosed pregnancies. Additionally, recurrent pregnancy loss affects approximately 5% of couples of childbearing age. Although there are several known causes of pregnancy loss in the first half, including parental chromosomal abnormalities, uterine malformations the possible role of placental growth factor (PLGF) remains unclear. The aim of this study was to evaluate the possible predictive role of serum and urinary PLGF for miscarriages in the first trimester of pregnancy.

MATERIALS AND

METHODS

Case-control studies were conducted. The study included 347 pregnant women, the group of miscarriages comprised 156 and the control group 191. The study did not include patients with serious health problems or high risk of miscarriage. Miscarriages were identified: confirmed clinical and ultrasound signs of embryo/fetal expulsion, anembryonic pregnancy and missed abortion. Concentrations of serum and urinary PLGF were detected by ELISA.

RESULTS

Serum PLGF concentrations in miscarriage were 19.8 (12.7-31.9) pg/mL, which was significantly lower than serum PLGF concentrations in uncomplicated pregnancy of 45.5 (25.4-60.0) pg/mL p <0.0001. ROC analysis revealed the diagnostic significance of serum PLGF: AUC 0.765 (CI 0.717-0.809) (p <0.0001), Se 84.6% (CI 77.7-90.0) Sp 68.7% (61.7-75.1), with cut-off ≤35.6 pg/mL, diagnostic odds ratio (DOR) 12. Odds ratio for miscarriages for serum PLGF concentration <35.6 pg/mL was 10.9 (6.5-18.4). Evaluation of urinary PLGF did not reveal diagnostic and prognostic efficacy of miscarriages.

CONCLUSION

The serum PLGF might be considered as a prediction marker of the miscarriages with a suggested cut off concentration of 35.6 pg/mL. A further investigation should be carried out on the larger cohorts from various geographical areas.