Huifang Huang,1 Sumei Wang2 

1Department of Obstetrics, The Third Affiliated Hospital of Guangxi Medical University, The Second Nanning People’s Hospital, Nanning, Guangxi, 530031, People’s Republic of China; 2Department of Obstetrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, People’s Republic of China

Correspondence: Sumei Wang, Department of Obstetrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, People’s Republic of China, Tel +86 13788014821, Email 187176076@qq.com

Objective: This study aimed to assess the predictive capacity of placenta growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) levels in the serum of pregnant women during early pregnancy (11– 13+6 weeks) for fetal growth restriction (FGR).
Patients and Methods: A retrospective cohort study was conducted involving 1602 pregnant women who gave birth at The Second Nanning People’s Hospital between March 2018 and September 2019. Serum concentrations of PlGF and PAPP-A were measured during early pregnancy for all participants. Based on pregnancy outcomes, participants were categorized into the FGR group (n = 94) and the normal control group (n = 1508). Clinical characteristics, serum PAPP-A, and PlGF levels during early pregnancy (11– 13+6 weeks) were compared between the two groups using t-tests and one-way analysis of variance. Receiver operating characteristic (ROC) curves were generated to assess the predictive value of each biomarker.
Results: The overall incidence of FGR in the study cohort was 5.86%. Pregnant women in the FGR group exhibited significantly lower serum levels of PlGF and PAPP-A compared to the control group (both p< 0.05). Correlation analysis revealed that PAPP-A levels were inversely associated with maternal age, pre-pregnancy body mass index (BMI), platelet count, and fibrinogen (all p< 0.05). ROC analysis demonstrated that the area under the curve (AUC) for predicting FGR was 0.734 (95% CI: 0.677– 0.790) for PlGF and 0.729 (95% CI: 0.676– 0.781) for PAPP-A, which indicates a certain individual predictive value. When combined, the predictive efficiency slightly improved (AUC=0.742).
Conclusion: Serum levels of PlGF and PAPP-A in early pregnancy can effectively predict FGR, with slightly improved predictive accuracy when used together, presenting a new method for early FGR screening.

Keywords: fetal growth restriction, pregnancy-associated plasma protein-A, PLACENTA growth factor, predictive value