TESTING for low placental growth factor (PlGF) during routine gestational diabetes screening could serve as an effective tool to identify pregnant individuals at high risk of early preterm birth. Recent research suggests that measuring PlGF levels around mid-pregnancy, typically between 24 to 28 weeks, may help clinicians pinpoint those at heightened risk, thereby enabling targeted interventions and closer monitoring.
This cohort study was conducted between 2020 and 2023 at an urban tertiary care centre, involving 9,037 singleton pregnancies. All participants received standard prenatal care, and their PlGF levels were measured during gestational diabetes screening. The primary outcome measured was early preterm birth, defined as delivery before 34 weeks, with secondary outcomes including stillbirth, preeclampsia, and low birth weight.
The analysis revealed that PlGF levels below 100 pg/mL were associated with a significantly increased likelihood of early preterm birth, showing a 79.4-fold increase in risk. Additionally, low PlGF levels were present in over 50% of iatrogenic preterm births and 30% of antepartum stillbirths. The predictive accuracy of low PlGF for early preterm birth showed an area under the curve (AUC) of 0.80, indicating strong discriminatory ability. For iatrogenic preterm births specifically, the AUC was even higher at 0.90, suggesting that PlGF screening is particularly useful in predicting medically indicated preterm births.
The results of this study indicate that mid-pregnancy PlGF testing could be a valuable clinical tool for identifying individuals at risk of adverse birth outcomes, particularly those likely to require iatrogenic preterm delivery. Given that early preterm birth poses considerable risks to neonatal health, PlGF testing could allow healthcare providers to focus resources on high-risk patients, potentially improving outcomes for both mothers and infants. This targeted approach could be especially valuable in tertiary care settings, where more intensive monitoring and intervention could be allocated to those most likely to benefit.
Reference
Gladstone RA et al. Midpregnancy Placental Growth Factor Screening and Early Preterm Birth. JAMA Netw Open. 2024. DOI: 10.1001/jamanetworkopen.2024.44454.
