Poster Presentation Society of Obstetric Medicine of Australia and New Zealand and Australasian Diabetes in Pregnancy Society Joint Scientific Meeting 2017

Urinary PlGF in preeclampsia and intrauterine fetal growth restriction - an alternative to circulating biomarkers (#105)

KEWEI KW ZHANG 1 , Monica Zen , Vincent Lee , Indika Alahakoon
  1. Westmead Hospital, Sydney, NSW, Westmead, NSW, Australia

Preeclampsia is a pregnancy specific complication associated with alterations in angiogenic factors placental growth factor (PIGF) and soluble fms-like tyrosine kinase 1 (sFlt-1). Most studies of preeclampsia have assessed the value of serum, but not urinary, measurements of sFlt-1 and PIGF. Apart from proteinuria/albuminuria, urinary biomarkers of preeclampsia and intrauterine fetal growth restriction (IUGR) are lacking. The objective of this study was to investigate whether urinary PIGF and sFlt-1 are suitable as markers in preeclampsia and IUGR. We also aimed to compare test characteristics of these biomarkers and compare these to circulating markers.  A cross-sectional case control study was conducted on 50 pregnant women between 24-40 weeks of gestation recruited and classified into four groups: normal pregnancy (N), preeclampsia (PE), preeclampsia plus IUGR (PE+IUGR), and IUGR respectively. Urine and blood were collected from the subjects (n = 20 N, n = 18 PE and PE+ IUGR, n = 12 IUGR) at term. ELISA was used to measure plasma and urinary PlGF and sFlt-1. There was a significant correlation between plasma PlGF and urine PlGF normalized to creatinine in preeclampsia and normal controls.  We found reduced urinary PlGF (p-value <0.001) and increased sFlt-1 (p-value <0.05), as well as increased sFlt-1 to PlGF ratio (p-value <0.05) in groups with PE, PE+IUGR, and IUGR only compared to normal controls. There is no difference of urinary PIGF and sFlt-1 between the PE, PE+IUGR and IUGR groups.  The results of our study suggest that urinary PIGF/Creatinine can differentiate between normal and pregnancy complications of preeclampsia and IUGR. Measurement of urinary PIGF may be an alternative to measurement of plasma biomarkers in assessing for preeclampsia. We suggest a future prospective longitudinal study to examine the value of urinary PIGF in predicting development and severity of preeclampsia and IUGR.