Role of Placental Growth Factor in Predicting Birth Growth in Intrauterine Growth-Restricted Pregnancies and Its Correlation With Placental Histopathology: An Exploratory Study.

PURPOSE: This study aimed to evaluate the relationship among maternal serum placental growth factor (PlGF), placental histopathology, and intrauterine growth restriction (IUGR). METHODS: This prospective exploratory study was conducted in a Level III neonatal unit between January 2018 and June 2019. Mothers with singleton pregnancies between 30 and 40 weeks of gestation with ultrasound-detected IUGR (n = 41), as well as gestation-matched mothers with normal pregnancies (n = 42), and their neonates were enrolled. Maternal PlGF was measured at the time of IUGR detection in the IUGR group and at comparable gestational ages in the control group admitted with risk for preterm birth. Placental histopathological examination was performed after delivery. Neonatal weight, length, and occipitofrontal circumference were recorded at birth. The outcome measures were maternal PlGF levels, placental histopathology findings in IUGR versus normal pregnancies, and neonatal growth parameters at birth. RESULTS: At >37 weeks of gestation, the median (IQR) PlGF level was significantly lower in the IUGR group (35 (13, 51) pg/mL) than in the normal pregnancy group (108 (65, 220) pg/mL; p < 0.001), but the difference was not significant at <37 weeks. Maternal PlGF showed a significant positive correlation with birth weight (p = 0.001), length (p = 0.03), occipitofrontal circumference (p = 0.016), and placental histopathology (p = 0.001). Gross placental examination showed lower mean placental weight in IUGR pregnancies compared with normal controls. Features of placental underperfusion due to impaired maternal vascular supply, such as intervillous and perivillous fibrin deposition and foci of calcification, were more common in IUGR placentas than in normal pregnancies. CONCLUSIONS: PlGF levels and placental histopathology were positively correlated with anthropometric measures at birth. Placental weight, placental histopathological changes, and gestational age are significant independent predictors of birth weight and length in IUGR cases.