Low urinary placental growth factor is a marker of pre-eclampsia

Abstract

Recent reports of increased serum levels of soluble fms-like tyrosine kinase 1 (sFlt-1) and decreased levels of placental growth factor (PlGF) suggest the key role of angiogenic factors in development of pre-eclampsia. PlGF is excreted in urine, and reduced urinary level has been suggested as a marker of this condition as well as help in its prediction. We measured urinary PlGF and creatinine values in 69 pregnant women (35 with pre-eclampsia and 34 normotensive controls). Over 70% patients had severe pre-eclampsia. Compared to controls, the urinary PlGF and PlGF/creatinine levels were significantly reduced in women with pre-eclampsia. The hospital stay was longer and fetal outcomes poorer in this group. Three normotensive women who showed very low levels developed pre-eclampsia 2-6 weeks later. Reduced urinary PlGF level in a pregnant woman is a marker of pre-eclampsia. The value of reduced urinary PlGF levels in predicting pre-eclampsia in currently normotensive pregnant women needs to be evaluated. A simple predictive test is likely to be of value in the developing countries.