Placental Growth Factor as a Prognostic Tool in Women With Hypertensive Disorders of Pregnancy
Placental Growth Factor as a Prognostic Tool in Women With Hypertensive Disorders of Pregnancy
复制标题
胎盘生长因子作为妊娠期高血压疾病女性的预后工具
作者：
U. Ukah;J. Hutcheon;B. Payne;Matthew D. Haslam;M. Vatish;J. Ansermino;H. Brown;L. Magee;P. von Dadelszen
PlGF（胎盘生长因子）已在很大程度上被证明与妊娠高血压疾病（HDPs）的诊断相关;然而，目前还不清楚它对病情的预后有多大作用。我们的目的是提供一个总结的重要发现，其预后能力的系统审查的研究，检查能力的PlGF，无论是独立或与其他因素相结合，预测母亲和胎儿并发症所造成的HDPs。我们纳入了2017年1月30日之前发表的研究，报告了使用PlGF作为确诊的HDPs或疑似先兆子痫女性的预后检测。在通过MEDLINE、Embase和CINAHL（护理和相关健康文献累积索引）确定的220篇摘要中，有17项研究符合我们的审查条件。通过敏感性、特异性、似然比和受试者工作特征曲线下面积评估预后性能。PlGF显示了中到高的证据（似然比≥5或≥ 0.2或受试者工作特征曲线下面积≥0.70），用于识别早产或新生儿结局风险最高的女性（10/12项研究），但未显示出预测不良母体结局的临床有用性能。PlGF可能有助于管理患有HDPs的妇女，以避免胎儿并发症。未来的研究应该确定一个最佳阈值的标志物，以指导交付，并应检查是否可以改善其用于预测不良孕产妇结局的妇女与HDPs。
The PlGF (placental growth factor) has been largely demonstrated to be associated with the diagnosis of the hypertensive disorders of pregnancy (HDPs); however, it is unclear how useful it is for the prognosis of the condition. Our objective was to provide a summary of important findings of its prognostic ability by systematically reviewing studies that examined the ability of the PlGF, either independently or combined with other factors, to predict maternal and fetal complications resulting from the HDPs. We included studies published before January 30, 2017, reporting on the use of the PlGF as a prognostic test for women with confirmed HDPs or suspected preeclampsia. Of the 220 abstracts identified through MEDLINE, Embase, and CINAHL (Cumulative Index to Nursing and Allied Health Literature), 17 studies were eligible for our review. Prognostic performance was evaluated by sensitivity, specificity, likelihood ratios, and area under the receiver operating characteristic curve. PlGF showed moderate-to-high evidence (likelihood ratios of ≥5 or ⩽0.2 or area under the receiver operating characteristic curves ≥0.70) for identifying women at the highest risk of preterm delivery or neonatal outcomes (10/12 studies) but showed no clinically useful performance for the prediction of adverse maternal outcomes. PlGF may aid in the management of women with HDPs to avert fetal complications. Future studies should determine an optimum threshold for the marker to guide delivery and should examine whether its use for predicting adverse maternal outcomes in women with HDPs can be improved.