Urinary PlGF predicts early-onset preeclampsia.(Obstetrics)

VIENNA -- Decreased urinary placental growth factor at midgestation is strongly associated with the subsequent development of early-onset preeclampsia, S. Ananth Karumanchi, M.D., reported.

"Low urinary PIGF antedates the clinical diagnosis of preeclampsia and may serve as a screening test to predict who will develop early-onset disease," Dr. Karumanchi said at the 14th World Congress of the International Society for the Study of Hypertension in Pregnancy.

The findings, published soon after the congress, come from a nested case-control study within the Calcium for Preeclampsia Prevention trial of healthy nulliparous women enrolled at five U.S. university medical centers during 1992-1995. Frozen serum and urine samples from 120 women with preeclampsia were compared with those of 120 matched normotensive controls (JAMA 2005;293:77-85).

In all the women, urinary PlGF levels increased during the first two trimesters, with a more rapid increase after 21-24 weeks and a peak at 29-33 weeks. However, those levels were significantly lower among the women who subsequently developed preeclampsia at weeks 25-28, 29-32, and 33-36. Differences were particularly large between the controls and the women who subsequently developed preeclampsia before 37 weeks or who had preeclampsia with a small-for-gestational age (SGA) infant.

Alterations in urinary PIGF levels at 21-32 weeks were also more pronounced in women who subsequently developed preeclampsia before 37 weeks (87 pg/mL) than among those who had onset of preeclampsia at term (223 pg/mL).

At 33-42 weeks, those levels were 22 vs. 118 pg/mL, lead author Richard J. Levine, M.D., of the National Institute of Child Health and Human Development, Bethesda, Md., and his associates reported in the published article.

The women were divided by quartiles of urinary PlGF obtained at 21-32 weeks' gestation and the results adjusted for gestational age at specimen collection, storage time, body ...