Retrospective analysis links low placental growth factor to increased fetal macrosomia and adverse outcomes.
INTRODUCTION: Abnormal maternal placental growth factor (PlGF) levels are linked to adverse pregnancy outcomes such as preeclampsia (PET), small for gestational age, and fetal growth restriction. This study aimed to examine the association between maternal PlGF levels and fetal macrosomia, a relationship that is not well established. METHODS: Retrospective cohort study of 355 patients. Placental growth factor levels were categorized as Low (5% or lower) or Normal (10% or higher). The primary outcome was fetal macrosomia, defined as estimated fetal weight greater than the 90th percentile on ultrasound. Secondary outcomes included abnormal placental morphology, maternal BMI, diabetes, chronic hypertension, PET, birth weight greater than the 90th percentile (CPSS), preterm birth less than 34 weeks, delivery mode, neonatal intensive care unit (NICU) admission, and placental pathology. Study approved by REB-USask (#Bio3702). RESULTS: Low maternal PlGF was significantly associated with fetal macrosomia ( P =.02; odds ratio 2.01; 95% CI, 1.1–3.6). Macrosomia was also associated with maternal diabetes ( P =.007) and higher maternal BMI ( P =.01). Macrosomic fetuses had nearly 17 times higher odds of birth weight greater than the 90th percentile ( P <.0001) and 2.8 times higher odds of NICU admission ( P =.007). CONCLUSIONS/IMPLICATIONS: In this preliminary cohort, low maternal PlGF levels were significantly associated with fetal macrosomia. Additionally, macrosomia was strongly linked to maternal diabetes, elevated BMI, high birth weight, and increased NICU admissions. These findings suggest PlGF may have potential as a predictive biomarker for macrosomia, warranting further investigation.
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Figueiro-Filho et al. (2026) studied this question.
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