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EP.012
Distinct longitudinal profiles of placental growth factor exist in women with chronic hypertension who develop placental disease

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• Chronic hypertension is frequently associated with poor pregnancy outcomes including pre-eclampsia ± fetal growth restriction (FGR) requiring iatrogenic preterm birth
• Accurate, early pregnancy prediction of placental disease, even in high-risk groups such as those with chronic hypertension and previous pre-eclampsia, continues to impede the testing of preventative treatments.
• Low concentrations of placental growth factor throughout gestation have been shown to be associated with the development of placental disease
• It is possible that accurate prediction of placental disease is compromised by the heterogeneous aetiology of the underlying placental disease
 

We tested the hypothesis that different longitudinal placental growth factor (PlGF) profiles are associated with placental disease in a high risk cohort.

Interpretation:

• Prediction of severe pregnancy complications using PlGF in early pregnancy was modest, even in a high risk group
• A low (<5th centile) PlGF measurement taken before 18 weeks identified 18/30 women who subsequently developed placental disease requiring birth <34 weeks
• Amongst women with placental disease, there are different profiles of PlGF across gestation - this has implications for the accurate prediction of disease as no single time point will identify all cases of disease.
• Women who have an increasing PlGF in mid gestation are unlikely to develop early onset disease
• The different profiles of PlGF suggest there are likely different underlying aetiologies within early onset placental disease
• A small number of cases of early onset placental disease (n=4) had a normal PlGF until presentation of pre-eclampsia
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