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CC BY-NC-ND 4.0 · AJP Rep 2020; 10(03): e234-e240
DOI: 10.1055/s-0040-1713785
Case Report

Use of Placental Growth Factor for Trisomy 21 Screening in Pregnancy: A Systematic Review

Ahmad Badeghiesh
1   Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
,
Alexander Volodarsky-Perel
1   Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
2   Lady Davis Research Institute, Jewish General Hospital, Montreal, Quebec, Canada
,
Ariane Lasry
1   Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
,
Robert Hemmings
1   Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
3   Department of Obstetrics and Gynecology, CIUSS Ouest de l'Ile, Montreal, Quebec, Canada
,
Yaron Gil
1   Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
,
Jacques Balayla
1   Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
› Author Affiliations Funding None.
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Abstract

Background Prenatal serum screening is an important modality to screen for aneuploidy in pregnancy. The addition of placental growth factor (PLGF) to screen for trisomy 21 remains controversial.

Objective To determine whether the addition of PLGF to combined serum aneuploidy screening improves detection rates (DRs) for trisomy 21.

Study Design We performed a systematic review of the literature until October 2019 to determine the benefits of adding PLGF to prenatal screening. We performed a goodness-of-fit test and retrieved the coefficient of determinations (R 2) as a function of false positive rates (FPRs), providing mean-weighted improvements in the DRs after accounting for PLGF levels.

Results We identified 51 studies, of which 8 met inclusion criteria (834 aneuploidy cases and 105,904 euploid controls). DRs were proportional to FPR across all studies, ranging from 59.0 to 95.3% without PLGF and 61.0 to 96.3% with PLGF (FPR 1–5%). Goodness-of-fit regression analysis revealed a logarithmic distribution of DRs as a function of the FPR, with R 2 = 0.109 (no PLGF) and R 2 = 0.06 (PLGF). Two-sample Kolmogorov–Smirnov's test reveals a p-value of 0.44. Overall, addition of PLGF improves DRs of 3.3% for 1% FPR, 1.7% for 3% FPR, and 1.4% for 5% FPR, respectively.

Conclusion Addition of PLGF to prenatal screening using serum analytes mildly improves trisomy 21 DRs as a function of FPRs.

Keywords

PLGF - placental growth factor - trisomy 21 - prenatal screening - aneuploidy


Publication History

Received: 05 January 2020

Accepted: 05 March 2020

Article published online:
27 August 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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