Research Article: Real-world discrimination and incremental value of first-trimester placental growth factor for hypertensive disorders of pregnancy: a retrospective Chinese cohort
Abstract:
Placental growth factor (PlGF) contributes to first-trimester screening algorithms for preeclampsia, but its prognostic performance as an isolated biomarker in routine Chinese care is uncertain.
We performed a retrospective, single-centre cohort study among pregnancy episodes recorded in a hospital PlGF workbook. Pregnancy episodes were deduplicated, PlGF values were traced to source laboratory cells, and hypertensive disorders of pregnancy (HDP) were ascertained using unvalidated free-text discharge-diagnosis keywords. The primary operational window was 9 + 0 to 13 + 6 weeks; 11 + 0 to 13 + 6 weeks was evaluated separately. We compared PlGF with a parsimonious maternal-characteristics model containing age, pre-pregnancy body mass index (BMI), and nulliparity.
From 405 source rows, 380 pregnancy episodes were resolved; 310 met the primary criteria, including 27 HDP events (11 cases of preeclampsia and 16 of gestational hypertension). PlGF alone had an area under the curve (AUC) of 0.633 (95% bootstrap CI 0.523–0.738), and internally derived PlGF multiple of the median (MoM) had an AUC of 0.636 (0.533–0.740). In 308 complete records, the maternal-characteristics model had an apparent AUC of 0.740 (0.635–0.837), while adding log10(PlGF) yielded an AUC of 0.748 (0.638–0.849); paired ?AUC was 0.009 (95% CI ?0.019 to 0.037).
The findings are consistent with a modest association between lower first-trimester PlGF and subsequent HDP, but they do not support isolated clinical use or a deployable prediction model.
Introduction:
Placental growth factor (PlGF) contributes to first-trimester screening algorithms for preeclampsia, but its prognostic performance as an isolated biomarker in routine Chinese care is uncertain.
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