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New test predicted preeclampsia
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A test for placental growth factor was highly sensitive and superior to other methods in predicting preeclampsia in women presenting before 35 weeks’ gestation, according to data in a new study.
Lucy C. Chappell, PhD, and colleagues evaluated the diagnostic accuracy of a low plasma placental growth factor concentration test (Triage PlGF Test, Alere) in a prospective multicenter study. They performed the test on 625 women at 20 weeks’ gestation or later with suspected preeclampsia.
“The test is designed to differentiate women with preeclampsia from those with high BP alone,” Chappell, of King’s College, London, said in a press release. “Current tests for the condition only detect that it’s happening, rather than predicting it, and by that time the disease has progressed and has likely already caused organ damage.”
The primary outcome was delivery for confirmed preeclampsia within 14 days of testing. The definition of a positive test was placental growth factor concentration <5th percentile for gestational age. Calculation of percentiles was based on 1,366 samples from a control group of 247 women with normal pregnancies.
The test was highly sensitive for the 287 women enrolled before 35 weeks’ gestation (0.96; 95% CI, 0.89-0.99) and had negative predictive value for delivery for preeclampsia within 14 days (0.98; 95% CI, 0.93-0.995), although its specificity was lower (0.55; 95% CI, 0.48-0.61). Sensitivity was lower for the 137 women enrolled at 35 weeks’ and 36 weeks’ gestation (0.7; 95% CI, 0.58-0.81) and for the 201 enrolled at 37 weeks’ gestation or later (0.57; 95% CI, 0.46-0.68).
The area under the receiver operating characteristic curve for low placental growth factor (0.87) for predicting delivery for confirmed preeclampsia within 14 days of testing was greater than all other tests commonly in use, including systolic BP (0.67), diastolic BP (0.66), uric acid (0.68), alanine transaminase (0.61) and dipstick proteinuria (0.76), as well as any combination of those tests (P<.001 for all comparisons).
“The test identifies women at high risk for developing preeclampsia, so doctors can better monitor and treat the BP,” Chappell said in the press release. “It also prevents unnecessary hospitalizations of those who are not likely to develop preeclampsia.”
Disclosure: The study was funded in part by Alere. Several researchers report financial ties with Alere, Metabolomic Diagnostics, Perkin Elmer and Roche.
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