Abstract
Background: Small for gestational age is a pregnancy complication associated with a variety of adverse perinatal outcomes. The aim of the study was to investigate if sFlt-1/PlGF ratio is related to adverse short-term neonatal outcome in neonates small for gestational age in normotensive pregnancy. Methods: A prospective observational study was conducted. Serum sFlt-1/PlGF ratio was measured in women in singleton gestation diagnosed with fetus small for gestational age. Short-term neonatal outcome analyzed in the period between birth and discharge home. Results: Eighty-two women were included. Women with sFlt-1/PlGF ratio ≥33 gave birth to neonates with lower birthweight at lower gestational age. Neonates from high ratio group suffered from respiratory disorders and NEC significantly more often. They were hospitalized at NICU more often and were discharged home significantly later. sFlt-1/PlGF ratio predicted combined neonatal outcome with sensitivity of 73% and specificity of 82.2%. Conclusions: sFlt-1/PlGF ratio is a useful toll in prediction of short-term adverse neonatal outcome in SGA pregnancies.
Highlights
According to the consensus early fetal growth restriction (FGR) is diagnosed before 32 weeks of gestation with three solitary parameters: abdominal circumference (AC) < 3rd centile, estimated fetal weight (EFW) < 3rd centile and absent end-diastolic flow in the umbilical artery (UA), or with four contributory parameters: AC or EFW < 10th centile combined with a pulsatility index (PI) > 95th centile in either the UA or uterine artery
Late FGR is diagnosed beyond 32 weeks with two solitary parameters: AC or EFW < 3rd centile, or four contributory parameters: EFW or AC < 10th centile, AC or EFW crossing centiles by at least two quartiles on growth charts and cerebroplacental ratio < 5th centile or UA-PI >
We found that soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) ratio ≥33 predicted adverse neonatal outcome with high sensitivity and specificity
Summary
Small for gestational age (SGA) and fetal growth restriction (FGR) are complications of pregnancy that have been associated with a variety of adverse perinatal outcomes [1]. According to the consensus early FGR is diagnosed before 32 weeks of gestation with three solitary parameters: abdominal circumference (AC) < 3rd centile, estimated fetal weight (EFW) < 3rd centile and absent end-diastolic flow in the umbilical artery (UA), or with four contributory parameters: AC or EFW < 10th centile combined with a pulsatility index (PI) > 95th centile in either the UA or uterine artery. Late FGR is diagnosed beyond 32 weeks with two solitary parameters: AC or EFW < 3rd centile, or four contributory parameters: EFW or AC < 10th centile, AC or EFW crossing centiles by at least two quartiles on growth charts and cerebroplacental ratio < 5th centile or UA-PI >
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