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In Reply: Drs Carbillon and Uzan raise the question of whether concentrations of PlGF might be used to distinguish pregnancies with growth-retarded fetuses due to uteroplacental insufficiency from those with constitutionally small fetuses. While this is an important question, the Calcium for Preeclampsia Prevention trial did not include uterine artery Doppler ultrasonography data, so we were unable to make this distinction.

In our main study, urinary PlGF in the lowest quartile of the distribution of specimens obtained at 21 to 32 weeks of gestation from women who remained normotensive throughout pregnancy was strongly associated with the subsequent development of preeclampsia before 37 weeks. Low PlGF at 21 to 32 weeks was associated with an odds ratio for preeclampsia before 37 weeks that was 14-fold greater than that for preeclampsia occurring at later gestational age, regardless of the presence or absence of an SGA infant (odds ratios for the lowest vs . . . [Full Text of this Article]

Richard J. Levine, MD
Division of Epidemiology, Statistics, and Prevention Research
National Institute of Child Health and Human Development
Bethesda, Md

Franklin H. Epstein, MD
Division of Nephrology
Department of Medicine

S. Ananth Karumanchi, MD
sananth@bidmc.harvard.edu
Division of Nephrology
Departments of Medicine, Obstetrics, and Gynecology
Beth Israel Deaconess Medical Center
Boston, Mass

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