Angiogenic Marker Prognostic Models in Pregnant Women With Hypertension

Date

2020-03-01

Author

Perry, Helen
Binder, Julia
Kalafat, Erkan
Jones, Stuart
Thilaganathan, Basky
Khalil, Asma

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Angiogenic markers such as PlGF (placental growth factor) and sFlt-1 (soluble Fms-like tyrosine kinase-1) have been shown to be useful for predicting adverse outcome in women suspected of having preeclampsia. The aim of the current study was to evaluate the prognostic value of angiogenic markers and maternal risk factors in pregnant women with hypertension. This was a prospective study of pregnancies complicated by preeclampsia, gestational hypertension, or chronic hypertension presenting to 1 of 2 tertiary referral hospitals between May 2013 and May 2018. Maternal characteristics along with blood samples for angiogenic marker analysis were obtained from participants. The primary outcome was delivery related to preeclampsia within 1 and 2 weeks. In total, 302 women with hypertension were included in the study cohort. The baseline model included maternal body mass index, mean arterial pressure, and clinical diagnosis at the time of assessment. The use of sFlt-1/PIGF ratio combined with the baseline model significantly improved the area under the curve values for predicting delivery within a week (0.83 versus 0.88; P=0.025) or in 2 weeks (0.86 versus 0.93; P=0.001) due to preeclampsia-related events in gestational ages <35 weeks. The magnitude of increase in accuracy was 7.9% (-0.5% to 16.4%, posterior probability of increase: 96.7%) for sFlt-1/PlGF ratio. Our results emphasize the additive value of angiogenic biomarkers and the superior performance of a continuous scale of sFlt-1/PlGF ratio in the model. The added utility of angiogenic markers diminishes after 35 weeks' gestation.

Subject Keywords

Internal Medicine

URI

https://hdl.handle.net/11511/68323

Journal

HYPERTENSION

DOI

https://doi.org/10.1161/hypertensionaha.119.13997

Collections

Department of Statistics, Article

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Prognostic Value of Maternal Cardiovascular Hemodynamics in Women With Gestational Hypertension and Chronic Hypertension in Pregnancy Kalafat, Erkan; Perry, Helen; Bowe, Sophie; Thilaganathan, Basky; Khalil, Asma (Ovid Technologies (Wolters Kluwer Health), 2020-08-01) This study aimed to assess the prognostic value of cardiovascular assessment in women with gestational hypertension or chronic hypertension for the risk of preeclampsia and need for closer antenatal surveillance. This was a prospective study of pregnancies complicated by gestational hypertension or chronic hypertension presenting to St George's Hospital, between January 2015 and May 2018. A noninvasive ultrasonic cardiac output monitor was used to obtain cardiovascular variables of cardiac output (CO) and s...
The Prognostic Value of Angiogenic Markers in Twin Pregnancies to Predict Delivery Due to Maternal Complications of Preeclampsia Binder, Julia; Palmrich, Pilar; Pateisky, Petra; Kalafat, Erkan; Kussel, Lorenz; Zeisler, Harald; Munkhbaatar, March; Windsperger, Karin; Thilaganathan, Basky; Khalil, Asma (Ovid Technologies (Wolters Kluwer Health), 2020-07-01) The sFlt-1 (soluble fms-like tyrosine kinase-1), PlGF (placental growth factor), and their ratio are useful for predicting delivery because of preeclampsia in singleton pregnancies. Evidence on the utility of sFlt-1/PlGF ratio in twin pregnancies is lacking. We aimed to evaluate the predictive value of sFlt-1/PlGF ratio for delivery because of preeclampsia in twins. A retrospective data analysis of 164 twin pregnancies with suspected preeclampsia was performed. The sFlt-1/PlGF ratio, which was known to clin...
Maternal and Perinatal Outcomes of White Coat Hypertension During Pregnancy A Systematic Review and Meta-Analysis Johnson, Sonia; Liu, Becky; Kalafat, Erkan; Thilaganathan, Basky; Khalil, Asma (Ovid Technologies (Wolters Kluwer Health), 2020-07-01) The aim of this meta-analysis is to investigate whether white-coat hypertension (WCH) has an adverse effect on maternal, fetal, and neonatal outcomes. Medline, EMBASE,, and Cochrane Library databases were searched electronically in December 2019. The outcomes were compared between pregnant women with WCH and normotensive controls, women with chronic hypertension, gestational hypertension or any hypertensive disorder of pregnancy. Twelve studies were eligible for inclusion in the systematic review. Women wit...
Home blood pressure monitoring in the antenatal and postpartum period: A systematic review meta-analysis Kalafat, Erkan; Benlioglu, Can; Thilaganathan, Basky; Khalil, Asma (Elsevier BV, 2020-01-01) Recent evidence suggests that home blood pressure monitoring (HBPM) is an effective way of managing women with hypertensive disorders of pregnancy (HDP) without increasing adverse outcomes. The aim of this systematic review and meta-analysis was to investigate the safety and efficacy of HBPM during pregnancy.
Angiogenic markers and their longitudinal change for predicting adverse outcomes in pregnant women with chronic hypertension Binder, Julia; Kalafat, Erkan; Palmrich, Pilar; Pateisky, Petra; Khalil, Asma (2021-09-01) Background: Women with chronic hypertension are at increased risk for adverse maternal and perinatal outcomes. Maternal serum angiogenic markers, such as soluble fms-like tyrosine kinase 1 and placental growth factor, can be used to triage women with suspected preeclampsia. However, data about these markers in pregnant women with chronic hypertension are scarce. Objective: We aimed to evaluate the predictive accuracy of maternal serum levels of soluble fms-like tyrosine kinase 1, placental growth factor, an...

Citation Formats

H. Perry, J. Binder, E. Kalafat, S. Jones, B. Thilaganathan, and A. Khalil, “Angiogenic Marker Prognostic Models in Pregnant Women With Hypertension,” HYPERTENSION, pp. 755–761, 2020, Accessed: 00, 2020. [Online]. Available: https://hdl.handle.net/11511/68323.