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To the Editor: The study by Dr Levine and colleagues¹ showed that urinary placental growth factor (PlGF) was significantly lower beginning at 25 to 28 weeks of gestation among women who subsequently developed preeclampsia compared with normotensive controls. From an ancillary study, they also concluded that a low urinary PlGF concentration at 21 to 32 weeks of gestation may distinguish preeclampsia from intrauterine growth retardation in normotensive women. However, 239 women with term preeclampsia (37 weeks) were excluded from both the main and ancillary studies. It is therefore possible that many women who delivered a small-for-gestational-age (SGA) infant because of uteroplacental insufficiency were excluded because they developed the later preeclampsia that is often observed in these circumstances.²

Moreover, differentiating between women with preeclampsia before 37 weeks (of whom 85% delivered <37 weeks) and women who remained normotensive but delivered an SGA infant (of whom only 10% delivered <37 weeks) has . . . [Full Text of this Article]

Lionel Carbillon, MD, PhD
lionel.carbillon@jvr.ap-hop-paris.fr

Michele Uzan, MD
Department of Obstetrics and Gynecology
Assistance Publique-Hôpitaux de Paris
Paris, France

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