Association of first trimester serum level of placental growth factor (PlGF) and cervical length with onset of preterm labour


  • Ipsita Sahoo Department of Obstetrics and Gynecology, Military Hospital Ambala, Haryana, India
  • Madhusudan Dey Department of Obstetrics and Gynecology, Army College of Medical Sciences, Delhi, India
  • Jayamol A. Department of Obstetrics and Gynecology, INHS Dhanvantari, Andaman and Nicobar Islands, India



Cervical length, Perinatal mortality, Preterm labour, Placental growth factor (PlGF), Ultrasound


Background: Preterm labour (PTL) or premature labour is defined as one where labour starts before the 37th completed week.  The incidence of preterm birth is around 5-10% and it is the leading cause of perinatal morbidity and mortality. Diagnosis and treatment of PTL is challenging. However, owing to the availability of effective strategies for prevention of preterm birth, risk identification and early prediction is even more essential. This may provide opportunity for intervention and better obstetric care. Various biochemical markers were studied for prediction of preterm labour, but the sensitivity and specificity were found to be low. This study focuses on determining whether serum level of PlGF and ultrasound measure of cervical length at 10 – 14 weeks period of gestation can be used for early prediction of preterm labour.

Methods: 296 antenatal women participated in this prospective observational study carried out from Dec 2015 to Sep 2017 at a tertiary care hospital. Serum level of PlGF was determined at 10-14 weeks. In the same sitting, cervical length was measured by transvaginal sonography. All these patients were followed up in antenatal OPD for monitoring the onset of preterm labour.

Results: Incidence of preterm labour was 6.76 %. Maternal characteristics and obstetric factors were comparable in cases and controls. Serum PlGF level and cervical length values were lower in preterm labour group than term deliveries. But this result was not statistically significant.

Conclusions: Lower levels of PlGF and cervical length were seen in preterm labour group, although it was not found to be statistically significant.


Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. The lancet. 2008;371(9606):75-84.

Martin JA, Osterman MJ, Centers for Disease Control and Prevention (CDC). Preterm births—United States, 2006 and 2010. MMWR Surveill Summ. 2013;62(suppl 3):136-8.

Kane SC, da Silva Costa F, Brennecke S. First trimester biomarkers in the prediction of later pregnancy complications. BioMed Research International. 2014;2014.

Krauss T, Pauer HU, Augustin HG. Prospective analysis of placenta growth factor (PlGF) concentrations in the plasma of women with normal pregnancy and pregnancies complicated by preeclampsia. Hypertension in pregnancy. 2004;23(1):101-11.

Bastek JA, Brown AG, Anton L, Srinivas SK, D'addio A, Elovitz MA. Biomarkers of inflammation and placental dysfunction are associated with subsequent preterm birth. J Mat-Fet Neonatal Med. 2011;24(4):600-5.

Souka AP, Papastefanou I, Michalitsi V, Papadopoulos GK, Kassanos D. A predictive model of short cervix at 20–24 weeks using first‐trimester cervical length measurement and maternal history. Prenatal Diagnos. 2011;31(2):202-6.

Berghella V, Keeler S, To M, Althuisius S, Rust O. Effectiveness of cerclage according to severity of cervical length shortening: a meta‐analysis. Ultrasound Obstet Gynecol. 2010;35(4):468-73.

Allen VM, Wilson RD, Cheung A, Blight C, Désilets VA, Gagnon A, et al. Pregnancy outcomes after assisted reproductive technology. J Obstet Gynaecol Canada. 2006;28(3):220-33.

Cnattingius S, Villamor E, Johansson S, Bonamy A-KE, Persson M, Wikström A-K, et al. Maternal obesity and risk of preterm delivery. Jama. 2013;309(22):2362-70.

Atzeni I, Paoletti AM, Deiana SF, Meloni A, Guerriero S, Parodo G et al. W239 placental growth factor (PLGF): Correlations with placental function. Int J Gynecol Obstet. 2012;119:S782-3.

Carvalho MHB, Bitter RE, Brizot MA, Maganha PPS, Zugaib M. Cervical length at 11-14 weeks and 22–24 weeks gestation evaluated by transvaginal sonography, and gestational age at delivery. Ultrasound Obstet Gynaecol.2003;21(2):135-9.






Original Research Articles