Maternal serum placental growth factor combined with second trimester aneuploidy screening to predict small-for-gestation neonates without preeclampsia.

OBJECTIVE: To investigate the role of maternal serum placenta growth factor (PlGF) and quadruple test parameters in predicting the risk of small for gestational age (SGA) infants of mothers without preeclampsia.

MATERIALS AND METHODS: We prospectively enrolled 300 pregnant patients who underwent blood sampling at 15-18 weeks gestation and followed them until delivery. Cases with SGA neonate delivery (n = 100) were compared with matched AGA neonate controls (n = 200). The plasma PlGF and quadruple markers were measured by enzyme-linked immunosorbent assay. The results were analyzed with Mann-Whitney U tests, and regression analysis was used to develop a model for the prediction of SGA.

RESULTS: Women who delivered SGA neonates had decreased levels of PlGF (median 0.71 MoM versus 0.7 MoM; p < 0.01), hCG (median 0.97 MoM versus 1.06 MoM; p = 0.046) and uE3 (median 0.92 MoM versus 1.04 MoM) compared to the AGA group. AFP, hCG and inhibin-A levels did not differ significantly. A PlGF concentration <0.37 MoM had a sensitivity of 28.0% (95% CI: 19.5-37.9) and a specificity of 89.5% (95% CI: 84.4-93.4) for the prediction of SGA neonates without PE.

CONCLUSION: SGA neonates in the absence of PE could potentially be identified at 15-18 weeks of pregnancy.