Analyzing the clinical utility of placental growth factor as a triage test

Preterm preeclampsia (PE) is associated with significant maternal and neonatal morbidity, yet classifying patients at high versus low risk for acute adverse outcomes remains challenging. The objective of this study was to evaluate the relationship between placental growth factor (PlGF) and outcomes among patients with suspected PE who were managed as inpatients or outpatients. This was a secondary analysis of the Preeclampsia Triage by Rapid Assay (PETRA) study. PlGF was categorized as: very low (<12 pg/mL), intermediate (12–100 pg/mL) and normal (>100 pg/mL). The primary outcome was a composite maternal or neonatal adverse outcome (CMAO or CNAO). Overall, 341 (56.7%) patients were managed as inpatients and 260 (43.3%) were managed as outpatients. Two discordant groups were identified: inpatients with normal PlGF and outpatients with very low PlGF. This discordance highlights the potential value of PlGF testing in objective risk stratification beyond clinical triage alone.