Prognostic value of placental growth factor (PlGF) in “white-coat hypertension” in pregnant individuals

Capa

Citar

Texto integral

Acesso aberto Acesso aberto
Acesso é fechado Acesso está concedido
Acesso é fechado Acesso é pago ou somente para assinantes

Resumo

“White-coat hypertension” (WCH) in pregnant individuals is associated with an increased risk of adverse pregnancy outcomes.

The aim: to establish a correlation between the levels of placental growth factor (PlGF) in the second trimester of pregnancy and preeclampsia in females with WCH.

Material and methods. Observational prospective study included 88 pregnant individuals, divided into 2 groups: 1st – 44 females with WCH, 2nd – 44 women with normal blood pressure (BP). Estimation of clinical factors, 24-hour blood pressure monitoring, laboratory and instrumental studies, assessment of serum PlGF, analysis of the course and outcomes of pregnancy was performed.

Results. The most common cardiometabolic risk factors in pregnant individuals with WCH were abdominal obesity and anamnestic data on previous preeclampsia. According to 24-hour BP monitoring data, pregnant women with WCH had higher systolic and diastolic BP during the day and at night, as well as average daytime heart rate, comparatively to pregnant individuals with normal BP. In the presence of WCH, the course of pregnancy was more often complicated by gestational diabetes mellitus, preeclampsia, premature birth, placental abruption, low birth weight babies, and antenatal fetal death. The threshold value of PlGF ≤ 179.74 pg/ml, measured at 14–20 weeks of pregnancy, showed sufficient prognostic value for late preeclampsia (area under the ROC curve is 0.815, sensitivity 80.0%, specificity 77.78%).

Conclusion. PlGF can be used as a predictor of preeclampsia development in pregnant individuals with WCH.

Texto integral

Acesso é fechado

Sobre autores

Ekaterina Nikolenko

South Ural State Medical University of the Ministry of Healthcare of Russia

Email: nikolenkokate@yandex.ru
ORCID ID: 0000-0003-4958-4695
Código SPIN: 2336-1822

MD, assistant at the Department of faculty therapy

Rússia, Chelyabinsk

Vasily Chulkov

Yaroslav-the-Wise Novgorod State University

Email: vschulkov@rambler.ru
ORCID ID: 0000-0002-0952-6856
Código SPIN: 8001-0051

MD, Dr. Sci. (Medicine), professor of the Department of internal medicine

Rússia, Veliky Novgorod

Elena Syundyukova

South Ural State Medical University of the Ministry of Healthcare of Russia

Email: seg269@mail.ru
ORCID ID: 0000-0001-9535-1871

MD, Dr. Sci. (Medicine), associate professor, professor of the Department of obstetrics and gynaecology

Rússia, Chelyabinsk

Veronika Sumerkina

South Ural State Medical University of the Ministry of Healthcare of Russia

Email: veronika.sumerkina@mail.ru
ORCID ID: 0000-0003-4842-0875
Código SPIN: 5831-4416

MD, PhD (Medicine), head of the Central Research Department

Rússia, Chelyabinsk

Lyubov Pykhova

South Ural State Medical University of the Ministry of Healthcare of Russia

Email: Lyubov_pykhova@mail.ru
ORCID ID: 0000-0003-0658-7626
Código SPIN: 3226-6247

MD, PhD (Biology), biologist at the Research Institute of Immunology

Rússia, Chelyabinsk

Vladislav Chulkov

South Ural State Medical University of the Ministry of Healthcare of Russia

Autor responsável pela correspondência
Email: vlad.chulkov.1989@mail.ru
ORCID ID: 0000-0002-1948-8523
Código SPIN: 4425-4640

MD, PhD (Medicine), associate professor of the Department of faculty therapy

Rússia, Chelyabinsk

Bibliografia

  1. Стрюк Р.И., Бунин Ю.А., Гурьева В.М., Иртюга О.Б., Коков Л.С., Коломацкая О.Е. с соавт. Диагностика и лечение сердечно-сосудистых заболеваний при беременности 2018. Национальные рекомендации. Российский кардиологический журнал. 2018;23(7):156–200. [Stryuk RI, Bunin YuA, Gurieva VM, Irtyuga OB, Kokov LS, Kolomatskaya OE et al. National guidelines for diagnosis and treatment of cardiovascular diseases during pregnancy. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2018;23(7):156–200 (In Russ.)]. EDN: XUZQTZ. https://doi.org/10.15829/1560-4071-2018-7-156-200
  2. Magee LA, Brown MA, Hall DR, Gupte S, Hennessy A, Karumanchi SA et al. The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens. 2022;27:148–69. PMID: 35066406. https://doi.org/10.1016/j.preghy.2021.09.008
  3. Кобалава Ж.Д., Конради А.О., Недогода С.В., Шляхто Е.В., Арутюнов Г.П., Баранова Е.И. с соавт. Артериальная гипертензия у взрослых. Клинические рекомендации 2024. Российский кардиологический журнал. 2024;29(9):230–329. [Kobalava ZhD, Konradi AO, Nedogoda SV, Shlyakhto EV, Arutyunov GP, Baranova EI et al. 2024 Clinical practice guidelines for hypertension in adults. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2024;29(9):230–329 (In Russ.)]. EDN: GUEWLU. https://doi.org/10.15829/1560-4071-2024-6117
  4. Brown MA, Mangos G, Davis G, Homer C. The natural history of white coat hypertension during pregnancy. BJOG. 2005;112(5):601–6. PMID: 15842284. https://doi.org/10.1111/j.1471-0528.2004.00516.x
  5. Mussarat N, Biggio J Jr, Martin J, Morgan J, Tivis R, Elmayan A, Williams FB. Masked pregnancy-associated hypertension as a predictor of adverse outcomes. Am J Obstet Gynecol MFM. 2023;5(7):100976. PMID: 37098390. https://doi.org/10.1016/j.ajogmf.2023.100976
  6. Johnson S, Liu B, Kalafat E, Thilaganathan B, Khalil A. Maternal and perinatal outcomes of white coat hypertension during pregnancy: A systematic review and meta-analysis. Hypertension. 2020;76(1):157–66. PMID: 32450741. https://doi.org/10.1161/hypertensionaha.119.14627
  7. Fang Y, Zuo L, Duan H, Huang C, Wen J, Yang Q et al. Hypertension phenotypes and adverse pregnancy outcome-related office and ambulatory blood pressure thresholds during pregnancy: A retrospective cohort study. Hypertens Res. 2025;48(1):77–87. PMID: 39152252. https://doi.org/10.1038/s41440-024-01837-x
  8. Sung S-H, Cheng H-M, Wang K-L, Yu W-C, Chuang S-Y, Ting C-T et al. White coat hypertension is more risky than prehypertension: Important role of arterial wave reflections. Hypertension. 2013;61(6):1346–53. PMID: 23608649. PMCID: PMC4536898. https://doi.org/10.1161/hypertensionaha.111.00569
  9. Чулков В.С., Николенко Е.С., Чулков Вл.С. Гипертензия белого халата у беременных. Южно-Российский журнал терапевтической практики. 2022;3(4):25–31. [Chulkov VS, Nikolenko ES, Chulkov VlS. White-coat hypertension in pregnant women. Yuzhno-Rossiyskiy zhurnal terapevticheskoy praktiki = South Russian Journal of Therapeutic Practice. 2022;3(4):25–31 (In Russ.)]. EDN: KXZJXI. https://doi.org/10.21886/2712-8156-2022-3-4-25-31
  10. Chulkov VS, Nikolenko E, Chulkov VlS, Podzolko A. White-coat hypertension in pregnant women: Risk factors, pregnancy outcomes, and biomarkers. Folia Med (Plovdiv). 2023;65(4):539–45. PMID: 37655372. https://doi.org/0.3897/folmed.65.e99159
  11. Stepan H, Galindo A, Hund M, Schlembach D, Sillman J, Surbek D, Vatish M. Clinical utility of sFlt-1 and PlGF in screening, prediction, diagnosis and monitoring of pre-eclampsia and fetal growth restriction. Ultrasound Obstet Gynecol. 2023;61(2):168–80. PMID: 35816445. https://doi.org/10.1002/uog.26032
  12. Сюндюкова Е.Г., Чулков В.С., Рябикина М.Г. Преэклампсия: современное состояние проблемы. Доктор.Ру. 2021;20(1):11–16. [Syundyukova EG, Chulkov VS, Ryabikina MG. Preeclampsia: The current state of the problem. Doctor.Ru. 2021;20(1):11–16 (In Russ.)]. EDN: RVLGPE. https://doi.org/10.31550/1727-2378-2021-20-1-11-16
  13. Chappell LC, Duckworth S, Seed PT, Griffin M, Myers J, Mackillop L et al. Diagnostic accuracy of placental growth factor in women with suspected preeclampsia: A prospective multicenter study. Circulation. 2013;128(19):2121–31. PMID: 24190934. https://doi.org/10.1161/circulationaha.113.003215
  14. Agrawal S, Cerdeira AS, Redman C, Vatish M. Meta-analysis and systematic review to assess the role of soluble FMS-like tyrosine kinase-1 and placenta growth factor ratio in prediction of preeclampsia: The SaPPPhirE Study. Hypertension. 2018;71(2):306–16. PMID: 29229743. https://doi.org/10.1161/hypertensionaha.117.10182
  15. Agrawal S, Shinar S, Cerdeira AS, Redman C, Vatish M. Predictive performance of PlGF (Placental Growth Factor) for screening preeclampsia in asymptomatic women: A systematic review and meta-analysis. Hypertension. 2019;74(5):1124–35. PMID: 31522621. https://doi.org/10.1161/hypertensionaha.119.13360
  16. Duffy JMN, Cairns AE, Magee LA, von Dadelszen P, van ‘t Hooft J, Gale C et al.; International Collaboration to Harmonise Outcomes for Pre-eclampsia (iHOPE). Standardising definitions for the preeclampsia core outcome set: A consensus development study. Pregnancy Hypertens. 2020;21:208–17. PMID: 32674052. https://doi.org/10.1016/j.preghy.2020.06.005
  17. Cuspidi C, Sala C, Tadic M, Rescaldani M, Grassi G, Mancia G. Is white-coat hypertension a risk factor for carotid atherosclerosis? A review and meta-analysis. Blood Press Monit. 2015;20(2):57–63. PMID: 25405819. https://doi.org/10.1097/MBP.0000000000000094
  18. Mancia G, Facchetti R, Bombelli M, Cuspidi C, Grassi G. White-coat hypertension: Pathophysiological and clinical aspects: Excellence award for hypertension research 2020. Hypertension. 2021;78(6):1677–88. PMID: 34757765. PMCID: PMC9634724. https://doi.org/10.1161/hypertensionaha.121.16489
  19. Rodrigues Â, Barata C, Marques I, Almeida MC. Diagnosis of white coat hypertension and pregnancy outcomes. Pregnancy Hypertens. 2018;14:121–24. PMID: 30527098. https://doi.org/10.1016/j.preghy.2018.08.452
  20. Tucker KL, Bankhead C, Hodgkinson J, Roberts N, Richard S, Heneghan C et al. How do home and clinic blood pressure readings compare in pregnancy? Hypertension. 2018;72(3):686–94. PMID: 30354754. PMCID: PMC6080884. https://doi.org/10.1161/hypertensionaha.118.10917
  21. Duhig KE, Myers J, Seed PT, Sparkes J, Lowe J, Hunter RM et al.; PARROT trial group. Placental growth factor testing to assess women with suspected pre-eclampsia: A multicentre, pragmatic, stepped-wedge cluster-randomised controlled trial. Lancet. 2019;393(10183):1807–18. PMID: 30948284. PMCID: PMC6497988. https://doi.org/10.1016/S0140-6736(18)33212-4

Arquivos suplementares

Arquivos suplementares
Ação
1. JATS XML
2. Fig. Detection of normal and low serum levels of placental growth factor (PIGF) in comparison groups

Baixar (66KB)

Declaração de direitos autorais © Bionika Media, 2025