{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T11:29:12Z","timestamp":1784028552473,"version":"3.55.0"},"reference-count":57,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T00:00:00Z","timestamp":1676332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the role of mid\u2010trimester placental growth factor (PlGF) in patients with abnormal circulating levels of first\u2010trimester biomarkers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study including singleton pregnancies complicated by abnormal first\u2010trimester biomarkers (2017\u20132020). Pregnancies complicated with chromosomal\/structural anomalies were excluded. All patients had ultrasound imaging including uterine artery Doppler combined with measurement of maternal circulating PlGF. Sonographic findings, maternal and perinatal outcomes, and placental histopathology were compared between pregnancies with normal and low (&lt;10th percentile for gestational age) PlGF levels. The diagnostic accuracy of PlGF for the prediction of specific placental\u2010mediated complications was compared with the uterine artery Doppler assessment and additional sonographic findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010one pregnancies were assessed, of which 35 (49.3%) had low PlGF levels. Maternal sociodemographic characteristics, nulliparity, and aspirin consumption were comparable. In comparison with patients with normal PlGF levels, individuals with low PlGF levels had a higher rate of fetal growth restriction (EFW &lt;3rd centile; 42.9% vs. 8.3%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001), preterm\u2010preeclampsia (22.9% vs. 0%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.002), preterm delivery &lt;34\u00a0weeks (54.3% vs. 8.3%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) and maternal vascular malperfusion placental pathology (72.7% vs. 21.7%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) following delivery. Adjusting for uterine artery Doppler and fetal biometry status, mid\u2010trimester low PlGF remained significantly associated with these placental\u2010mediated complications. The predictive capacity of PlGF outperformed ultrasound imaging with only minimal diagnostic improvement when ultrasound information was combined with PlGF status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In pregnancies with unexplained abnormal first\u2010trimester biomarkers, mid\u2010trimester PlGF outperformed a comprehensive ultrasound assessment in the identification of a subset of patients destined to develop placental dysfunction. This blood test may be an alternative initial approach in this context, especially where access to specialist care is more geographically challenging.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6327","type":"journal-article","created":{"date-parts":[[2023,2,4]],"date-time":"2023-02-04T16:55:00Z","timestamp":1675529700000},"page":"1044-1055","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comparison of circulating maternal placenta growth factor levels and sonographic evaluation of patients with abnormal first trimester screening analytes"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3016-6282","authenticated-orcid":false,"given":"Eran","family":"Ashwal","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics and Gynecology Hamilton Health Sciences McMaster University  Hamilton Ontario 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