{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:12:46Z","timestamp":1792080766600,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T00:00:00Z","timestamp":1665964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003123","name":"Fetal Medicine Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003123","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the effect of self\u2010declared race on serum placental growth factor (PlGF) and sFlt\u20101\/PlGF ratio and the impact on pre\u2010eclampsia (PE) prediction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Two UK maternity hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>29\u2009035 women with singleton pregnancies attending a routine 35<jats:sup>+0<\/jats:sup> to 36<jats:sup>+6<\/jats:sup> weeks' gestation hospital visit, including 654 (2.3%) who subsequently developed PE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The predictive performance of PlGF and sFlt\u20101\/PlGF for PE in minority racial groups (versus white) was examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measure<\/jats:title><jats:p>Delivery with PE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with white women, mean PlGF was higher and sFlt\u20101\/PlGF ratio lower in black, South Asian, East Asian and mixed race women. In white women at a PlGF concentration cut\u2010off corresponding to a screen\u2010positive rate (SPR) of 10%, detection rates (DRs) were 49.1% for PE at any time and 72.3% for PE within 2\u2009weeks after screening. In black women, at the same PlGF concentration cut\u2010off for white women, the SPR was 5.5%, and DRs 33.6% and 55.0%, respectively; the number of PE cases was too small to evaluate screening performance in other racial groups. Using a fixed cut\u2010off in sFlt\u20101\/PlGF ratio to identify women at risk of developing PE, similarly diagnostically disadvantaged black women. Bias was overcome by adjusting metabolite concentrations for maternal characteristics and use of the competing risks model to estimate patient\u2010specific risks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Screening for PE with fixed cut\u2010offs in PlGF or sFlt\u20101\/PlGF diagnostically disadvantages black women. It is essential that measured levels of PlGF be adjusted for race as well as other maternal characteristics.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17296","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T03:34:15Z","timestamp":1664336055000},"page":"78-87","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Effect of race on the measurement of angiogenic factors for prediction and diagnosis of pre\u2010eclampsia"],"prefix":"10.1111","volume":"130","author":[{"given":"Alan","family":"Wright","sequence":"first","affiliation":[{"name":"Institute of Health Research University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4136-3070","authenticated-orcid":false,"given":"Peter","family":"von Dadelszen","sequence":"additional","affiliation":[{"name":"School of Life Course and Population Sciences, Institute of Women and Children's Health King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1355-610X","authenticated-orcid":false,"given":"Laura A.","family":"Magee","sequence":"additional","affiliation":[{"name":"School of Life Course and Population Sciences, Institute of Women and Children's Health King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5856-6072","authenticated-orcid":false,"given":"Argyro","family":"Syngelaki","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-5442","authenticated-orcid":false,"given":"Ranjit","family":"Akolekar","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Medway Maritime Hospital  Gillingham UK"},{"name":"Institute of Medical Sciences Canterbury Christ Church University  Chatham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dave","family":"Wright","sequence":"additional","affiliation":[{"name":"Institute of Health Research University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3515-7684","authenticated-orcid":false,"given":"Kypros H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,17]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"NICE Guidance.PlGF\u2010based testing to help diagnose suspected pre\u2010eclampsia (Triage PlGF test Elecsys immunoassay sFlt\u20101\/PlGF ratio DELFIA Xpress PlGF 1\u20132\u20103 test and BRAHMS sFlt\u20101 Kryptor\/BRAHMS PlGF plus Kryptor PE ratio). 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