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Placental biomarker and fetoplacental Doppler abnormalities are strongly associated with placental pathology in pregnancies with small‐for‐gestational‐age fetus: prospective study

Year: 2025

Type: article

Abstract: OBJECTIVE: Placental dysfunction can result in small-for-gestational age (SGA) or fetal growth restriction (FGR). The aim of this prospective cohort study was to assess the association of the cerebroplacental ratio (CPR) and other more conventional fetoplacental Doppler indices, circulating placental growth factor (PlGF) levels and soluble fms-like tyrosine kinase-1 (sFlt-1)/PlGF ratio, with specific placental abnormalities in a large cohort of pregnancies with an SGA/FGR fetus. METHODS: centile and abnormal placental biomarkers (PlGF level < 100 ng/L and sFlt-1/PlGF ratio > 5.78 if gestational age < 28 weeks or > 38 if gestational age ≥ 28 weeks) on the following placental abnormalities, classified based on the Amsterdam Placental Workshop Group Consensus criteria: placental maternal vascular malperfusion (MVM), fetal vascular malperfusion (FVM), villitis of unknown etiology (VUE), chronic histiocytic intervillositis (CHI) and delayed villous maturation (DVM). RESULTS: centile (aOR, 4.01 (95% CI, 2.25-7.13); P < 0.001) was present. The odds of placental abnormality were also significantly higher if PlGF levels were < 100 ng/L (aOR, 3.66 (95% CI, 2.22-6.06); P < 0.001) or the sFlt-1/PlGF ratio was elevated (aOR, 3.74 (95% CI, 2.17-6.43); P < 0.001). The odds of MVM were also higher in women with PlGF < 100 ng/L (aOR, 2.89 (95% CI, 1.72-4.85); P < 0.001) and elevated sFlt-1/PlGF ratio (aOR, 3.15 (95% CI, 1.83-5.45); P < 0.001). CONCLUSION: centile, PlGF < 100 ng/L and elevated sFlt-1/PlGF ratio were all strongly associated with placental abnormality, particularly MVM. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Source: Ultrasound in Obstetrics and Gynecology

DOI: 10.1002/uog.29237