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PEDIATRICS Vol. 113 No. 5 May 2004, pp. 1348-1351

Placenta Growth Factor Elevation in the Cord Blood of Premature Neonates Predicts Poor Pulmonary Outcome

Po-Nien Tsao, MD^*, Shu-Chen Wei, MD, Yi-Ning Su, MD, Chien-Nan Lee, MD, MPH^||, Hung-Chieh Chou, MD^*, Wu-Shiun Hsieh, MD^* and Fon-Jou Hsieh, MD^||

^* Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
Department of Medical Genetics, National Taiwan University College of Medicine, Taipei, Taiwan
^|| Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine

Objective. To determine whether an elevated placenta growth factor (PlGF) level in cord blood is associated with increased risk for preterm infants to develop bronchopulmonary dysplasia (BPD).

Methods. Sixty-three preterm infants who were born at 34 weeks' gestation or earlier were enrolled. Two infants who died before 28 days' postnatal age could not be assigned a BPD status and were excluded. PlGF levels in cord blood were measured using enzyme-linked immunosorbent assay. Mann-Whitney rank sum test, Spearman correlation coefficients, and multivariable linear or logistic regression analyses were used for statistical analysis.

Results. The BPD group had a higher PlGF level, lower gestational age, lower birth weight (BW), higher incidence of endotracheal tube intubation, and longer duration of intubation. The PlGF levels in cord blood correlated negatively with gestational age and BW. However, multivariable logistic regression analyses revealed that only elevated cord blood PlGF levels and BW were associated with BPD after adjusting for all contributing factors. Furthermore, an increased PlGF level in cord blood was significantly correlated with the clinical severity of BPD, as measured by duration of intubation. At 17 mg/dL, the specificity of cord blood PlGF level in predicting BPD was 95%, the sensitivity was 53%, the positive predictive value was 83%, and the negative predictive value was 82%.

Conclusions. Measuring cord blood PlGF level at birth might be a biological marker for predicting the occurrence of BPD and allowing early therapeutic intervention.

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Key Words: bronchopulmonary dysplasia • cord blood • placenta growth factor

Abbreviations: BPD, bronchopulmonary dysplasia • PlGF, placenta growth factor • VEGF, vascular endothelial growth factor • GA, gestational age • RDS, respiratory distress syndrome • BW, birth weight

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Received for publication May 23, 2003; Accepted Sep 19, 2003.

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