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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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Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License
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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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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
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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...
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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.