Placental angiogenic factors : Useful factor for prediction of preeclampsia abut not of small for gestational = Placental angiogenic factors : Useful factor for prediction of preeclampsia abut not of small for gestational

국문 초록 (Abstract)

목적: To investigate the value of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) for predicting preeclampsia or small for gestational age (SGA) in pregnant women.
방법: This prospective cohort single center study was conducted in 474 women with singleton pregnancy. We measured plasma levels of pregnancy- associated plasma protein-A(PAPP-A), serum levels of alpha-fetoprotein (MSAFP), unconjugated estriol (uE3), inhibin-A and human chorionic gonadotropin (hCG) at 15+0 to 20+6 weeks of gestation. We also assessed the plasma levels of sFlt-1 and PlGF at 24+0 to 28+6 and 29+0 to 37+6 weeks of gestation, using the Elecsys assay and calculated sFlt-1/PlGF ratio. Uterine artery doppler ultrasonography with color flow mapping was performed at 20+0 to 24+6 weeks of gestation.
결과: Respectively, 29 and 19women had SGA fetus or preeclampsia comparing to 426 uncomplicated pregnant women with AGA fetus. In PE group, the level of sFlt-1 and sFlt-1/PlGF ratio were higher (2nd : 2630.5 vs 1389, 10 vs 2.6, p<0.05; 3rd : 7295 vs 2386, 83.7 vs 8.25, p<0.05) and the level of PlGF was significantly lower (2nd : 215.9 vs 530.1, p<0.05; 3rd : 119.9 vs 294.95, p<0.05) than control group in 2nd trimester and 3rd trimester. However, in SGA group, these factors didn’t show significant difference in both second trimester and third trimester. The time-dependent slope of the sFlt-1/PlGF ratio between 2nd and 3rd trimester was significantly steeper in PE compared to control and SGA group. Such as Uterine artery resistance index, pulsatility index and S/D ratio in SGA group, but not in PE group.
결론: Measurements of PlGF, sFlt-1 and sFlt-1/PlFT ratio were useful markers for the prediction of preeclampsia but not of SGA.