Evidence map›Paper›PMID 33901486›Full record

ArticleAmerican journal of obstetrics and gynecology2021

Slowing of fetal growth and elevated maternal serum sFLT1:PlGF are associated with early term spontaneous labor.

Ulla Sovio, Francesca Gaccioli, Emma Cook, D Stephen Charnock-Jones, Gordon C S Smith

Open access · hybridAbstract read
In one paragraph

Article in American journal of obstetrics and gynecology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 17 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. First Trimester Placental Biomarkers for Pregnancy Outcomes.International journal of molecular sciences · 2024
    Review
  5. Article
  6. Article
  7. A novel indicator of selectionEvolution, medicine, and public health · 2023
    Article
  8. Routine first-trimester pre-eclampsia screening and risk of preterm birth.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2022
    Article
  9. Placental Syndromes-A New Paradigm in Perinatology.International journal of environmental research and public health · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 2 countries.

Ulla SovioDepartment of Obstetrics and Gynaecology, University of Cambridge, Cambridge, United Kingdom; NIHR Cambridge Biomedical Research Centre, Cambridge, United Kingdom; Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom. Electronic address: us253@medschl.cam.ac.uk.
Francesca GaccioliDepartment of Obstetrics and Gynaecology, University of Cambridge, Cambridge, United Kingdom; NIHR Cambridge Biomedical Research Centre, Cambridge, United Kingdom; Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom.
Emma CookDepartment of Obstetrics and Gynaecology, University of Cambridge, Cambridge, United Kingdom; NIHR Cambridge Biomedical Research Centre, Cambridge, United Kingdom.
D Stephen Charnock-JonesDepartment of Obstetrics and Gynaecology, University of Cambridge, Cambridge, United Kingdom; NIHR Cambridge Biomedical Research Centre, Cambridge, United Kingdom; Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom.
Gordon C S SmithDepartment of Obstetrics and Gynaecology, University of Cambridge, Cambridge, United Kingdom; NIHR Cambridge Biomedical Research Centre, Cambridge, United Kingdom; Centre for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom. Electronic address: gcss2@cam.ac.uk.
University of Cambridge · GB

Funding

Department of HealthMedical Research Council G1100221
6 · The paper itself

Abstract

backgroundThe physiological control of human parturition at term is unknown.

objectiveThis study aimed to test the hypothesis that slowing of fetal growth or elevated maternal serum levels of markers of placental hypoxia in late gestation will be associated with earlier term labor. STUDY

designWe observed 2208 women having first births and performed serial blinded ultrasonography and immunoassay of soluble fms-like tyrosine kinase-1 and placenta growth factor. We estimated the probability of spontaneous delivery from 37 weeks of gestational age concerning (1) fetal growth between 20 and 36 weeks of gestational age and (2) the maternal serum soluble fms-like tyrosine kinase-1-to-placenta growth factor ratio measured at approximately 36 weeks of gestational age. Data were analyzed using logistic regression and Cox regression.

resultsFetal size at 36 weeks of gestational age was not independently associated with the timing of delivery at term. However, there was an inverse relationship between fetal growth between 20 weeks of gestational age and 36 weeks of gestational age and the probability of spontaneous labor at 37 to 38 weeks' gestation (hazard ratio [95% confidence interval] for a 50 percentile increase in abdominal circumference growth velocity, 0.60 [0.47-0.78]; P=.0001). This association was weaker at 39 to 40 weeks' gestation (0.83 [0.74-0.93]; P=.0013), and there was no association at ≥41 weeks' gestation. Very similar associations were observed for estimated fetal weight growth velocity. There was a positive relationship between soluble fms-like tyrosine kinase-1-to-placenta growth factor ratio and the probability of spontaneous labor at 37 to 38 weeks' gestation (hazard ratio [95% confidence interval] for a 50 percentile increase in soluble fms-like tyrosine kinase-1-to-placenta growth factor ratio, 3.05 [2.32-4.02]; P<.0001). This association was weaker at 39 to 40 weeks' gestation (1.46 [1.30-1.63]; P<.0001), and there was no association at ≥41 weeks' gestation. Adjustment for maternal characteristics was without material effect on any of these associations.

conclusionSlowing of fetal growth and biomarkers of placental insufficiency were associated with an increased probability of early onset of spontaneous term labor. We speculated that progressive placental insufficiency may be a physiological phenomenon that occurs with advancing gestational age near and at term and promotes the initiation of labor.

Indexed as

Fetal DevelopmentLabor, ObstetricAdultBiomarkersCohort StudiesFemaleGestational AgeHumansPlacenta Growth FactorPlacental InsufficiencyPregnancyUltrasonography, PrenatalVascular Endothelial Growth Factor Receptor-1BiomarkersFLT1 protein, humanPlacenta Growth FactorVascular Endothelial Growth Factor Receptor-1fetal growthfetal stressplacental insufficiencypregnancyprotein biomarkersspontaneous labor

Identifiers

PMID33901486
PMCPMC8568041
OpenAlexW3158663090

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.