Chorionic thickness and PlGF concentrations as early predictors of small-for-gestational age birth weight in a low risk population
Abstract
Objectives: SGA is associated with higher incidence of postnatal complications, including suboptimal neurodevelopment and increased cardiovascular risk. Screening for SGA, carried out at 11–13 (+ 6d) gestational weeks enables to reduce or completely eliminate the above mentioned complications. The aim of this study was to assess the correlation between chorionic thickness, concentration of PIGF protein and foetal birth weight in a single low-risk pregnancy.
Material and methods: The study included 76 patients at 11–13 (+ 6d) gestational weeks, monitored throughout pregnancy. Ultrasound examinations identified the location and thickness of the chorion by measuring it in its central part at its widest point in a sagittal section. Additionally, at each visit venous blood was collected to determine the level of PlGF, PAPP-A, and BhCG.
Results: A significant positive correlation (r = 0.37) was found between the foetal weight and chorionic thickness. This correlation was affected by the location of the chorion and a significant negative correlation was observed between the level of PLGF, FHR, weight and length of the newborn. Maternal early-pregnancy BMI did not affect neonatal weight and body length, FHR, chorionic thickness, and the levels of PlGF, PAPP-A, and BhCG.
Conclusions: The preliminary analysis indicates an association between chorionic thickness assessed during ultrasound at 11–13 (+ 6d) gestational weeks, PIGF levels assayed at the same time and birth weight. Increasing chorion thickness was accompanied by increasing foetal birth weight. PlGF level showed an inversely proportional effect on the foetal weight. This correlation was significant for the posterior location of the chorion.
Keywords: SGAchorion thicknessnewborn birth weightultrasound
References
- Ropacka-Lesiak M. Wewnątrzmaciczne ograniczenie wzrastania płodu. In: Bręborowicz GH. ed. Położnictwo Tom 2 Medycyna matczyno-płodowa. PZWL, Warszawa, Warszawa 2012: 105–117.
- Lobmaier SM, Figueras F, Mercade I, et al. Angiogenic factors vs Doppler surveillance in the prediction of adverse outcome among late-pregnancy small-for- gestational-age fetuses. Ultrasound Obstet Gynecol. 2014; 43(5): 533–540.
- Salafia CM, Charles AK, Maas EM. Placenta and fetal growth restriction. Clin Obstet Gynecol. 2006; 49(2): 236–256.
- Salafia CM, Maas E, Thorp JM, et al. Measures of placental growth in relation to birth weight and gestational age. Am J Epidemiol. 2005; 162(10): 991–998.
- Salafia CM, Zhang J, Charles AK, et al. Placental characteristics and birthweight. Paediatr Perinat Epidemiol. 2008; 22(3): 229–239.
- Williams LA, Evans SF, Newnham JP. Prospective cohort study of factors influencing the relative weights of the placenta and the newborn infant. BMJ. 1997; 314(7098): 1864–1868.
- Akolekar R, Zaragoza E, Poon LCY, et al. Maternal serum placental growth factor at 11 + 0 to 13 + 6 weeks of gestation in the prediction of pre-eclampsia. Ultrasound Obstet Gynecol. 2008; 32(6): 732–739.
- Poon LCY, Kametas NA, Maiz N, et al. First-trimester prediction of hypertensive disorders in pregnancy. Hypertension. 2009; 53(5): 812–818.
- Thadhani R, Mutter WP, Wolf M, et al. First trimester placental growth factor and soluble fms-like tyrosine kinase 1 and risk for preeclampsia. J Clin Endocrinol Metab. 2004; 89(2): 770–775.
- Vatten LJ, Eskild A, Nilsen TIL, et al. Changes in circulating level of angiogenic factors from the first to second trimester as predictors of preeclampsia. Am J Obstet Gynecol. 2007; 196(3): 239.e1–239.e6.
- Cowans NJ, Stamatopoulou A, Tørring N, et al. First trimester maternal serum placental growth factor in trisomy 21 pregnancies. Prenat Diagn. 2010; 30(5): 449–453.
- Węgrzyn P, Borowski D, Wielgoś M. Badanie przesiewowe w kierunku preeclampsi . In: Wielgoś M, Borowski D, Wielgoś M. ed. Nadciśnienie tętnicze w ciąży. Via Medica, Gdańsk, Gdańsk 2010: 39–49.
- Berger P, Sturgeon C, Bidart JM, et al. The ISOBM TD-7 Workshop on hCG and Related Molecules . Tumor Biology. 2002; 23(1): 1–38.
- Cole LA. Immunoassay of human chorionic gonadotropin, its free subunits, and metabolites. Clin Chem. 1997; 43(12): 2233–2243.
- Schwartz N, Sammel MD, Leite R, et al. First-trimester placental ultrasound and maternal serum markers as predictors of small-for-gestational-age infants. Am J Obstet Gynecol. 2014; 211(3): 253.e1–253.e8.
- Costa SL, Proctor L, Dodd JM, et al. Screening for placental insufficiency in high-risk pregnancies: is earlier better? Placenta. 2008; 29(12): 1034–1040.
- Proctor LK, Toal M, Keating S, et al. Placental size and the prediction of severe early-onset intrauterine growth restriction in women with low pregnancy-associated plasma protein-A. Ultrasound Obstet Gynecol. 2009; 34(3): 274–282.
- Toal M, Chaddha V, Windrim R, et al. Ultrasound detection of placental insufficiency in women with elevated second trimester serum alpha-fetoprotein or human chorionic gonadotropin. J Obstet Gynaecol Can. 2008; 30(3): 198–206.
- Toal M, Chan C, Fallah S, et al. Usefulness of a placental profile in high-risk pregnancies. Am J Obstet Gynecol. 2007; 196(4): 363.e1–363.e7.
- Viero S, Chaddha V, Alkazaleh F, et al. Prognostic value of placental ultrasound in pregnancies complicated by absent end-diastolic flow velocity in the umbilical arteries. Placenta. 2004; 25(8-9): 735–741.
- Fang SW, Ou CY, Tsai CC, et al. Second-trimester placental volume and vascular indices in the prediction of small-for-gestational-age neonates. Fetal Diagn Ther. 2015; 37(2): 123–128.