Evaluation of angiogenic factors in prediction of growth‐related neonatal morbidity at term and comparison with competing‐risks model

ABSTRACT Objectives First, to describe the distribution of biomarkers of impaired placentation in small‐for‐gestational‐age (SGA) pregnancies with neonatal morbidity; second, to examine the predictive performance for growth‐related neonatal morbidity of a high soluble fms‐like tyrosine kinase‐1 (sFlt‐1)/placental growth factor (PlGF) ratio or low PlGF; and, third, to compare the performance of a high sFlt‐1/PlGF ratio or low PlGF with that of the competing‐risks model for SGA in predicting growth‐related neonatal morbidity. Methods This was a prospective observational study of women attending for a routine hospital visit at 35 + 0 to 36 + 6 weeks' gestation in two maternity hospitals in England. The visit included recording of maternal demographic characteristics and medical history, an ultrasound scan and measurement of serum PlGF and sFlt‐1. The primary outcome was delivery within 4 weeks after assessment and at 38, the competing‐risks model using maternal risk factors and EFW predicted 77.5% (95% CI, 71.7–83.3%) of SGA