Birth Weight < 3rd Percentile Prediction Using Additional Biochemical Markers-The Uric Acid Level and Angiogenesis Markers (sFlt-1, PlGF)-An Exploratory Study

Overview

Journal Int J Environ Res Public Health

Publisher MDPI

Specialties Environmental Health
Public Health

Date 2022 Nov 26

PMID 36429778

Authors

Magdalena Bednarek-Jedrzejek

Sylwia Dzidek

Piotr Tousty

Ewa Kwiatkowska

Aneta Cymbaluk-Ploska

Tomasz Gora

Bartosz Czuba

Andrzej Torbe

Sebastian Kwiatkowski

Affiliations

Soon will be listed here.

Abstract

(1) Aim: Ultrasound is the gold standard for assessing fetal growth disorders. The relationship between high sFlt-1/PlGF scores and LBW (low birth weight) was described. In this study, we attempted to assess whether uric acid could be used as a secondary marker in estimating the pregnancy risk associated with LBW. (2) Material and methods: 665 pregnant women with a suspected or confirmed form of placental insufficiency were enrolled. In each of the patients, sFlt-1 and PlGF and uric acid levels were determined. Patients were divided into two groups according to birth weight below and above the third percentile for the given gestational age with the criteria of the neonatal definition of FGR (fetal growth restriction). (3) Results: A significant negative correlation between neonatal birth weight and the uric acid level across the entire study group was observed. We found a significant negative correlation between neonatal birth weight and the uric acid level with birth weights < 3rd percentile. (4) Conclusions: There is a significant link between the uric acid concentration and LBW in the group with placental insufficiency. Uric acid can improve the prediction of LBW. An algorithm for LBW prognosis that makes use of biophysical (ultrasound) and biochemical (uric acid level, angiogenesis markers) parameters yields better results than using these parameters separately from each other.

References

Dukhovny S, Zera C, Little S, McElrath T, Wilkins-Haug L . Eliminating first trimester markers: will replacing PAPP-A and βhCG miss women at risk for small for gestational age?. J Matern Fetal Neonatal Med. 2014; 27(17):1761-4. DOI: 10.3109/14767058.2013.879703. View

Troger B, Muller T, Faust K, Bendiks M, Bohlmann M, Thonnissen S . Intrauterine growth restriction and the innate immune system in preterm infants of ≤32 weeks gestation. Neonatology. 2013; 103(3):199-204. DOI: 10.1159/000343260. View

Westergaard J, Teisner B, Hau J, Grudzinskas J . Placental protein measurements in complicated pregnancies. I. Intrauterine growth retardation. Br J Obstet Gynaecol. 1984; 91(12):1216-23. DOI: 10.1111/j.1471-0528.1984.tb04740.x. View

Spencer K, Cowans N, Avgidou K, Molina F, Nicolaides K . First-trimester biochemical markers of aneuploidy and the prediction of small-for-gestational age fetuses. Ultrasound Obstet Gynecol. 2007; 31(1):15-9. DOI: 10.1002/uog.5165. View

Carreras L, Vermylen J, Spitz B, Van Assche A . "Lupus" anticoagulant and inhibition of prostacyclin formation in patients with repeated abortion, intrauterine growth retardation and intrauterine death. Br J Obstet Gynaecol. 1981; 88(9):890-4. DOI: 10.1111/j.1471-0528.1981.tb02224.x. View

Sun W, Li C, Zhang H, Ren W, Cui L, Yuan X . [The correlation between serum uric acid levels in the third trimester of pregnancy and adverse pregnancy outcomes]. Zhonghua Nei Ke Za Zhi. 2021; 60(5):446-452. DOI: 10.3760/cma.j.cn112138-20200521-00502. View

Bednarek-Jedrzejek M, Kwiatkowski S, Ksel-Hryciow J, Tousty P, Nurek K, Kwiatkowska E . The sFlt-1/PlGF ratio values within the <38, 38-85 and >85 brackets as compared to perinatal outcomes. J Perinat Med. 2019; 47(7):732-740. DOI: 10.1515/jpm-2019-0019. View

Visan V, Scripcariu I, Socolov D, Costescu A, Rusu D, Socolov R . Better prediction for FGR (fetal growth restriction) with the sFlt-1/PIGF ratio: A case-control study. Medicine (Baltimore). 2019; 98(26):e16069. PMC: 6616245. DOI: 10.1097/MD.0000000000016069. View

Kumar N, Singh A, Maini B . Impact of maternal serum uric acid on perinatal outcome in women with hypertensive disorders of pregnancy: A prospective study. Pregnancy Hypertens. 2017; 10:220-225. DOI: 10.1016/j.preghy.2017.10.002. View

10.

Whetham J, Muggah H, Davidson S . Assessment of intrauterine growth retardation by diagnostic ultrasound. Am J Obstet Gynecol. 1976; 125(5):577-80. DOI: 10.1016/0002-9378(76)90775-4. View

11.

Colella M, Frerot A, Rideau Batista Novais A, Baud O . Neonatal and Long-Term Consequences of Fetal Growth Restriction. Curr Pediatr Rev. 2018; 14(4):212-218. PMC: 6416241. DOI: 10.2174/1573396314666180712114531. View

12.

Longo S, Bollani L, Decembrino L, Di Comite A, Angelini M, Stronati M . Short-term and long-term sequelae in intrauterine growth retardation (IUGR). J Matern Fetal Neonatal Med. 2012; 26(3):222-5. DOI: 10.3109/14767058.2012.715006. View

13.

McCowan L, Figueras F, Anderson N . Evidence-based national guidelines for the management of suspected fetal growth restriction: comparison, consensus, and controversy. Am J Obstet Gynecol. 2018; 218(2S):S855-S868. DOI: 10.1016/j.ajog.2017.12.004. View

14.

Lind T, Godfrey K, Otun H, Philips P . Changes in serum uric acid concentrations during normal pregnancy. Br J Obstet Gynaecol. 1984; 91(2):128-32. DOI: 10.1111/j.1471-0528.1984.tb05895.x. View

15.

Briese V, Straube W . [Detection of pregnancy-specific beta 1-glycoproteins (SP1) and pregnancy-associated plasma protein A (PAPP-A) in maternal serum. Diagnostic significance in intrauterine fetal retardation]. Zentralbl Gynakol. 1984; 106(8):517-23. View

16.

Beune I, Bloomfield F, Ganzevoort W, Embleton N, Rozance P, van Wassenaer-Leemhuis A . Consensus Based Definition of Growth Restriction in the Newborn. J Pediatr. 2018; 196:71-76.e1. DOI: 10.1016/j.jpeds.2017.12.059. View

17.

Kwiatkowski S, Bednarek-Jedrzejek M, Ksel J, Tousty P, Kwiatkowska E, Cymbaluk A . sFlt-1/PlGF and Doppler ultrasound parameters in SGA pregnancies with confirmed neonatal birth weight below 10th percentile. Pregnancy Hypertens. 2018; 14:79-85. DOI: 10.1016/j.preghy.2018.08.448. View

18.

Merviel P, Ba R, Beaufils M, Breart G, Salat-Baroux J, Uzan S . Lone hyperuricemia during pregnancy: maternal and fetal outcomes. Eur J Obstet Gynecol Reprod Biol. 1998; 77(2):145-50. DOI: 10.1016/s0301-2115(97)00248-0. View

19.

Escudero C, Bertoglia P, Acurio J, Escudero A . PP026. Hyperuricemia in the prognosis of adverse perinatal outcomes. Pregnancy Hypertens. 2015; 2(3):256-7. DOI: 10.1016/j.preghy.2012.04.137. View

20.

Sovio U, Goulding N, McBride N, Cook E, Gaccioli F, Charnock-Jones D . A maternal serum metabolite ratio predicts fetal growth restriction at term. Nat Med. 2020; 26(3):348-353. DOI: 10.1038/s41591-020-0804-9. View