{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T06:50:18Z","timestamp":1768719018678,"version":"3.49.0"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T00:00:00Z","timestamp":1698105600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003123","name":"Fetal Medicine Foundation","doi-asserted-by":"publisher","award":["1037116"],"award-info":[{"award-number":["1037116"]}],"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":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether serum placental growth factor (PlGF) at 19\u201323\u2009weeks of gestation can improve the identification of risk for adverse outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective observational cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Two English maternity units.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Unselected singleton pregnancies attending routine ultrasound at 19\u201323\u2009weeks of gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Outcomes ascertained by health record review. Diagnostic test properties evaluated clinical risk factors for pre\u2010eclampsia (according to National Institute of Care Excellence) or fetal growth restriction (according to Royal College of Obstetricians and Gynaecologists), low PlGF at 19\u201323\u2009weeks of gestation (&lt;5th percentile) or both.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Pre\u2010eclampsia, gestational hypertension, stillbirth, birthweight below third percentile or neonatal intensive care unit (NICU) admission for \u226548\u2009h.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 30\u2009013 pregnancies, risk factors were present in 9941 (33.1%), low PlGF was present in 1501 (5.0%) and both (\u2018two\u2010stage\u2019 screening) were present in 547 (1.8%) pregnancies. Risk factors detected 41.7%\u201354.7% of adverse outcomes, and could not meaningfully revise the risk (all positive likelihood ratios, +LR, &lt;5.0; all negative likelihood ratios, \u2212LR, \u22650.2). Low PlGF detected 8.5%\u201317.4% of adverse outcomes, but meaningfully increased risks (other than NICU admission) associated with delivery &lt;37\u2009weeks of gestation (+LR\u2009=\u20095.03\u201315.55); all \u2212LRs were \u22650.2. \u2018Two\u2010stage\u2019 screening detected 4.2%\u20138.9% of adverse outcomes, with meaningful +LRs (6.28\u201318.61) at &lt;37\u2009weeks of gestation, except for NICU admission of \u226548\u2009h, which had an +LR of 7.56 at &lt;34\u2009weeks of gestation; all \u2212LRs were \u22650.2. No screening strategy meaningfully increased or decreased the detection of adverse outcome risk at term.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Clinical risk factor screening has a high screen\u2010positive rate and a poor detection of adverse outcomes. False positives cannot be reduced by PlGF testing at 19\u201323\u2009weeks of gestation; therefore, this cannot be recommended as a useful strategy on its own.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17684","type":"journal-article","created":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T08:00:30Z","timestamp":1698134430000},"page":"803-810","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Placental growth factor testing at 19\u201323\u2009weeks of gestation as a guide to subsequent care in pregnancy: A prospective observational study"],"prefix":"10.1111","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1355-610X","authenticated-orcid":false,"given":"Laura A.","family":"Magee","sequence":"first","affiliation":[{"name":"Institute of Women and Children's Health, School of Life Course and Population Sciences, King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Argyro","family":"Syngelaki","sequence":"additional","affiliation":[{"name":"Institute of Women and Children's Health, School of Life Course and Population Sciences, King's College London  London UK"},{"name":"Fetal Medicine Research Institute, King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"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":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4136-3070","authenticated-orcid":false,"given":"Peter","family":"von\u00a0Dadelszen","sequence":"additional","affiliation":[{"name":"Institute of Women and Children's Health, School of Life Course and Population Sciences, King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1266-0711","authenticated-orcid":false,"given":"Kypros H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute, King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,10,24]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"NICE.Hypertension in pregnancy: diagnosis and management. 2019. [cited 2023 April 20]. Available from:https:\/\/www.nice.org.uk\/guidance\/ng133"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704559"},{"key":"e_1_2_12_4_1","unstructured":"Royal College of Obstetricians and Gynaecologists.The investigation and management of the small\u2010for\u2010gestational\u2010age fetus. Green\u2010top guideline No 31 RCOG. 2014."},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.122.20565"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.04.247"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.121.17047"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1975.tb00710.x"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003018"},{"key":"e_1_2_12_10_1","unstructured":"NICE.Hypertension in pregnancy. The management of hypertensive disorders during pregnancy. 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