RESULTS
Eighty-six women were admitted with the diagnosis of early-onset severe
PE during the study period, 68 of them fulfilled the inclusion criteria
and had no maternal complications and no fetal indication for immediate
delivery. Five were excluded for not collecting blood samples for
angiogenic factors due to a breach of the study protocol, leaving 63
women for analysis.
A total of 18 (28.6%) pregnancies had an adverse neonatal outcome,
non-exclusively including 2 (3.2%) stillbirths, 4 (6.4%) neonatal
demise, 1 (1.6%) neonatal acidosis, 9 (14.3%) 5-min Apgar score< 7, 5 (7.9%) bronchopulmonary dysplasia, 1 (1.6%)
necrotizing enterocolitis, 1 (1.6%) grade III intraventricular
hemorrhage, 2 (3.2%) hypoxic-ischemic encephalopathy, 1 (1.6%) acute
renal failure and 3 (4.8%) cardiac failures. Table 1 details the
characteristics of the study population, pregnancy outcomes and the
at-admission parameters by the occurrence of adverse neonatal outcomes.
Of note, among the angiogenic factors (PlGF, sFlt-1 and, sFlt-1/PlGF
ratio), the PlGF showed the largest difference between affected and
unaffected babies, and it was used in the subsequent multivariate
models. Table 2 shows the multivariate analysis for the association
between at-admission parameters and adverse neonatal outcomes.
Figure 1 and Table 3 show the predictive performance of different
combinations of at-admission predictors. Compared with the PREP-L score,
both the PREP-L + severe FGR (p=0.041) and PREP-L + PlGF (0.012)
significantly added predictive value. The combination of all parameters
(PREP-L score, severe FGR and PlGF) did not improve further the
prediction capacity.