Placental growth factor in assessment of women with suspected pre-eclampsia to reduce maternal morbidity: a stepped wedge cluster randomised control trial (PARROT Ireland)

When healthcare providers decide when to deliver a baby because of preeclampsia, they balance the potential harm to the mother of continuing the pregnancy with the potential harm to the baby of a preterm delivery. While delivery is appropriate care for women with clear cases of severe preterm preeclampsia, what to do in those with less clear signs and symptoms is uncertain. Researchers and clinicians agree that having a lab test to confirm preeclampsia when symptoms first appear could protect both mother and baby by making sure delivery is the appropriate treatment. In this clinical trial, researchers evaluated the impact of using a biomarker known as placental growth factor (PlGF) (which has been shown to be lower in those who go on to develop preeclampsia) in those with suspected preterm preeclampsia (between 20 and 35 weeks). Unfortunately, results showed the addition of PlGF to clinical care had no significant impact on predicting either maternal or neonatal illness or death.

Take home message:  Results do not support the use of PlGF testing into routine clinical care for women with suspected preterm preeclampsia.

Negative results are just as important as positive ones. This study contradicts other similar studies so researchers will need to examine important differences and discern new ways to use data from biomarkers to inform clinical care. For example, in this analysis, fetal growth restriction (FGR) - when the baby is substantially smaller than expected for that gestational age - was considered a risk factor for preterm preeclampsia, but sometimes FGR does not occur because of preeclampsia, so new studies may make it clearer how we should use PlGF in these cases.

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8361324/

About Research Roundup

Each quarter, our team of researchers reviews the most current studies related to hypertensive disorders of pregnancy and selects those studies they feel will be of greatest interest to our community to summarize.

Special thanks to our volunteer research team, who under the leadership of Dr. Elizabeth Sutton, make Research Roundup possible: Alisse Hauspurg, MD Felicia LeMoine, MD Jenny Sones, PhD, DVM, and Robin Trupp, PhD, RN.