Research output: Contribution to journal › Article › peer-review
Kate E Duhig, Paul T Seed, Anna Placzek, Jenie Sparkes, Eleanor Hendy, Carolyn Gill, Anna Brockbank, Andrew H Shennan, Shakila Thangaratinam, Lucy C Chappell
Original language | English |
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Pages (from-to) | 90-95 |
Number of pages | 6 |
Journal | Pregnancy Hypertension |
Volume | 24 |
Early online date | 3 Mar 2021 |
DOIs | |
E-pub ahead of print | 3 Mar 2021 |
Published | Jun 2021 |
Additional links |
OBJECTIVE: To assess the diagnostic performance of angiogenic biomarkers in determining need for delivery in seven days in women with late preterm preeclampsia.
STUDY DESIGN: In a prospective observational cohort study in 36 maternity units across England and Wales, we studied the diagnostic accuracy of placental growth factor (PlGF) and sFlt-1 in determining the risk of complications requiring delivery in late preterm (34+0 to 36+6 weeks' gestation) preeclampsia. Angiogenic biomarkers were measured using the Quidel (PlGF) and Roche (sFlt-1:PlGF ratio) assays. Additional clinical data was obtained for use within the established 'Prediction of complications in early-onset pre-eclampsia' (PREP)-S prognostic model. Biomarkers were assessed using standard methods (sensitivity, specificity, Receiver Operator Curve areas). Estimated probability of early delivery from PREP-S was compared to actual event rates.
MAIN OUTCOME MEASURES: Clinically indicated need for delivery for pre-eclampsia within seven days.
RESULTS: PlGF (Quidel) testing had high sensitivity (97.9%) for delivery within seven days, but negative predictive value was only 71.4%, with low specificity (8.4%), with similar results from sFlt-1/PlGF assay. The area under the curve for PlGF was 0.60 (SE 0.03), and 0.65 (0.03), and 0.64 (0.03) for PREP-S in combination with PlGF, and sFlt-1:PlGF, respectively.
CONCLUSIONS: Angiogenic biomarkers do not add to clinical assessment to help determine need for delivery for women with late preterm pre-eclampsia. Existing models developed in women with early-onset pre-eclampsia to predict complications cannot be used to predict clinically indicated need for delivery in women with late preterm pre-eclampsia.
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