Analyzing the Clinical Utility of Placental Growth Factor as a Triage Test

Preterm preeclampsia affects up to 8,000 pregnancies per year in the United States. Classifying those at high- vs. low-risk for acute adverse outcomes remains a challenge. Lower-risk patients may not require hospitalization and could be managed outpatient. The objective was to evaluate the relationship between Placental growth factor (PlGF) and outcomes among patients with suspected preeclampsia who were managed in the inpatient vs. outpatient setting. This was a secondary analysis of Preeclampsia Triage by Rapid Assay. PlGF categories were defined as: very low (less than 12 pg/mL), intermediate (12–100 pg/mL) and normal (> 100 pg/mL). The primary outcome was a composite adverse maternal or neonatal outcome (CMAO or CNAO). In our study, 341 (56.7%) patients were managed inpatient and 260 (43.3%) were managed outpatient. Among both the inpatient and outpatient groups, the rates of CMAO and CNAO were significantly increased in those with a very low PlGF, compared to the other groups. Two discrepant groups were identified: inpatients with normal PlGF and outpatients with very low PlGF. The addition of PlGF to clinical decision making may identify subgroups at highest risk for adverse outcome within a distinct time interval, as well as those with normal placental function who are lower risk.