Predicting Time to Delivery in Hypertensive Disorders: Assessing PlGF and sFlt-1 with the Novel Parameter ‘Mtp-Multiples of a Normal Term Placenta’
<b>Background:</b> Imbalanced angiogenesis is characteristic of normal placental maturation but it also signals placental dysfunction, underlying hypertensive disorders during pregnancy. This study aimed to investigate the relationship between angiogenic placental aging, measured by mark...
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MDPI AG
2024-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/7/1899 |
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| author | Valentina Giardini Alice Angela Francesca Santagati Elisabetta Marelli Marco Casati Anna Cantarutti Patrizia Vergani |
| author_facet | Valentina Giardini Alice Angela Francesca Santagati Elisabetta Marelli Marco Casati Anna Cantarutti Patrizia Vergani |
| author_sort | Valentina Giardini |
| collection | DOAJ |
| description | <b>Background:</b> Imbalanced angiogenesis is characteristic of normal placental maturation but it also signals placental dysfunction, underlying hypertensive disorders during pregnancy. This study aimed to investigate the relationship between angiogenic placental aging, measured by markers placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) using the new index “Multiples of a normal term placenta” (Mtp) and the duration of pregnancy. <b>Methods:</b> A retrospective observational study was conducted, including singleton pregnancies diagnosed or suspected of hypertensive disorders after the 20th gestational week. Mtp measures how far a single dosage of angiogenic marker deviates from the expected value in an uncomplicated full-term pregnancy (Mpt = sFlt-1/sFlt-1 reference value or PIGF/PIGF reference value). We considered the 90th, 95th, and 97.5th centiles for sFlt-1 and the 2.5th, 5th, and 10th centiles for PlGF as references. <b>Results:</b> The categories with longer time to delivery, regardless of gestational age, were: Mtp PlGF 10th c ≥ 2, ≥3 and Mtp sFlt-1 90th c ≤ 0.5 (median days of 9, 11, 15 days, respectively). These two categories Mtp sFlt-1 90th c ≥ 3 and Mtp sFlt-1 97.5th c ≥ 2 allow the identification of women at risk for imminent delivery within 1 day. Women who were deemed at low/medium risk based on the sFlt-1/PIGF ratio appeared to be at high risk when considering the individual values of sFlt-1 and/or PIGF. <b>Conclusions:</b> This new Mtp index for sFlt-1 and PlGF could be employed to assess the degree of placental aging in women with hypertensive disorders. It represents a valid tool for evaluating the risk of imminent birth, irrespective of gestational age, surpassing the current stratification based on the sFlt-1/PIGF ratio. |
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| language | English |
| last_indexed | 2024-04-24T10:41:50Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-02a44a93a46e46ab9620612f288acd232024-04-12T13:20:58ZengMDPI AGJournal of Clinical Medicine2077-03832024-03-01137189910.3390/jcm13071899Predicting Time to Delivery in Hypertensive Disorders: Assessing PlGF and sFlt-1 with the Novel Parameter ‘Mtp-Multiples of a Normal Term Placenta’Valentina Giardini0Alice Angela Francesca Santagati1Elisabetta Marelli2Marco Casati3Anna Cantarutti4Patrizia Vergani5Department of Obstetrics, IRCCS San Gerardo dei Tintori Foundation, University of Milano-Bicocca, 20900 Monza, ItalyDepartment of Obstetrics, IRCCS San Gerardo dei Tintori Foundation, University of Milano-Bicocca, 20900 Monza, ItalyDepartment of Obstetrics, MBBM Foundation Onlus, University of Milano-Bicocca, 20900 Monza, ItalyLaboratory Medicine, IRCCS San Gerardo dei Tintori Foundation, 20900 Monza, ItalyDivision of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milano, ItalyDepartment of Obstetrics, MBBM Foundation Onlus, University of Milano-Bicocca, 20900 Monza, Italy<b>Background:</b> Imbalanced angiogenesis is characteristic of normal placental maturation but it also signals placental dysfunction, underlying hypertensive disorders during pregnancy. This study aimed to investigate the relationship between angiogenic placental aging, measured by markers placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) using the new index “Multiples of a normal term placenta” (Mtp) and the duration of pregnancy. <b>Methods:</b> A retrospective observational study was conducted, including singleton pregnancies diagnosed or suspected of hypertensive disorders after the 20th gestational week. Mtp measures how far a single dosage of angiogenic marker deviates from the expected value in an uncomplicated full-term pregnancy (Mpt = sFlt-1/sFlt-1 reference value or PIGF/PIGF reference value). We considered the 90th, 95th, and 97.5th centiles for sFlt-1 and the 2.5th, 5th, and 10th centiles for PlGF as references. <b>Results:</b> The categories with longer time to delivery, regardless of gestational age, were: Mtp PlGF 10th c ≥ 2, ≥3 and Mtp sFlt-1 90th c ≤ 0.5 (median days of 9, 11, 15 days, respectively). These two categories Mtp sFlt-1 90th c ≥ 3 and Mtp sFlt-1 97.5th c ≥ 2 allow the identification of women at risk for imminent delivery within 1 day. Women who were deemed at low/medium risk based on the sFlt-1/PIGF ratio appeared to be at high risk when considering the individual values of sFlt-1 and/or PIGF. <b>Conclusions:</b> This new Mtp index for sFlt-1 and PlGF could be employed to assess the degree of placental aging in women with hypertensive disorders. It represents a valid tool for evaluating the risk of imminent birth, irrespective of gestational age, surpassing the current stratification based on the sFlt-1/PIGF ratio.https://www.mdpi.com/2077-0383/13/7/1899placental growth factor (PlGF)soluble fms-like tyrosine kinase (sFlt-1)hypertensive disorders of pregnancyplacental agingtiming of deliveryangiogenesis |
| spellingShingle | Valentina Giardini Alice Angela Francesca Santagati Elisabetta Marelli Marco Casati Anna Cantarutti Patrizia Vergani Predicting Time to Delivery in Hypertensive Disorders: Assessing PlGF and sFlt-1 with the Novel Parameter ‘Mtp-Multiples of a Normal Term Placenta’ Journal of Clinical Medicine placental growth factor (PlGF) soluble fms-like tyrosine kinase (sFlt-1) hypertensive disorders of pregnancy placental aging timing of delivery angiogenesis |
| title | Predicting Time to Delivery in Hypertensive Disorders: Assessing PlGF and sFlt-1 with the Novel Parameter ‘Mtp-Multiples of a Normal Term Placenta’ |
| title_full | Predicting Time to Delivery in Hypertensive Disorders: Assessing PlGF and sFlt-1 with the Novel Parameter ‘Mtp-Multiples of a Normal Term Placenta’ |
| title_fullStr | Predicting Time to Delivery in Hypertensive Disorders: Assessing PlGF and sFlt-1 with the Novel Parameter ‘Mtp-Multiples of a Normal Term Placenta’ |
| title_full_unstemmed | Predicting Time to Delivery in Hypertensive Disorders: Assessing PlGF and sFlt-1 with the Novel Parameter ‘Mtp-Multiples of a Normal Term Placenta’ |
| title_short | Predicting Time to Delivery in Hypertensive Disorders: Assessing PlGF and sFlt-1 with the Novel Parameter ‘Mtp-Multiples of a Normal Term Placenta’ |
| title_sort | predicting time to delivery in hypertensive disorders assessing plgf and sflt 1 with the novel parameter mtp multiples of a normal term placenta |
| topic | placental growth factor (PlGF) soluble fms-like tyrosine kinase (sFlt-1) hypertensive disorders of pregnancy placental aging timing of delivery angiogenesis |
| url | https://www.mdpi.com/2077-0383/13/7/1899 |
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