Automated electrochemiluminescence immunoassay for serum PlGF levels in women with singleton pregnancy at 9–13 weeks of gestation predicts preterm preeclampsia: a retrospective cohort study

Our aims were to obtain the gestational-age-specific median of common logarithmic placental growth factor (PlGF) values in the first trimester in women with a singleton pregnancy in order to generate the gestational-age-specific multiple of the median (MoM) of log 10 PlGF at 9–13 weeks of gestation, to evaluate screening parameters of MoM of log 10 PlGF at 9–13 weeks of gestation to predict preterm preeclampsia (PE), and to construct an appropriate prediction model for preterm PE using minimum risk factors in multivariable logistic regression analyses in a retrospective sub-cohort study. Preterm PE occurred in 2.9% (20/700), and PE in 5.1% (36/700). Serum PlGF levels were measured using Elecsys PlGF ® . MoMs of log 10 PlGF at 9–13 weeks of gestation in Japanese women with a singleton pregnancy followed a normal distribution. We determined the appropriate cut-off value of MoM of log 10 PlGF to predict preterm PE at around a10% false-positive rate (0.854). The MoM of log 10 PlGF < 0.854 yielded sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio (95% confidence interval [CI]), and negative likelihood ratio (95% CI) of 55.0%, 91.9%, 17.5%, 98.5%, 6.79 (4.22–10.91), and 0.49 (0.30–0.80), respectively. The combination of MoM of log 10 PlGF and presence of either chronic hypertension or history of PE/gestational hypertension (GH) yielded sensitivity and specificity of 80.0 and 85.7%, respectively, to predict preterm PE. In conclusion, the automated electrochemiluminescence immunoassay for serum PlGF levels in women with singleton pregnancy at 9–13 weeks of gestation may be useful to predict preterm PE.