Soluble fms-Like tyrosine kinase 1 (sFlt1), endoglin and placental growth factor (PlGF) in preeclampsia among high risk pregnancies.

Abstract

BACKGROUND:

Differences in circulating concentrations of antiangiogenic factors sFlt1 and soluble endoglin (sEng) and the pro-angiogenic growth factor PlGF are reported to precede the onset of preeclampsia weeks to months in low-risk pregnant women. The objective of this study was to investigate whether similar changes can be detected in pregnant women at high-risk to develop the syndrome.

METHODS:

This study is a secondary analysis of the NICHD MFMU trial of aspirin to prevent preeclampsia in high-risk pregnancies. Serum samples were available from 194 women with pre-existing diabetes, 313 with chronic hypertension, 234 with multifetal gestation, and 252 with a history of preeclampsia in a previous pregnancy. Samples collected across pregnancy were analyzed in a blinded fashion for sFlt1, sEng and PlGF.

RESULTS:

The odds of developing preeclampsia were significantly increased among women with multiple fetuses for each 2-fold elevation in sFlt1, sEng and the ratio of angiogenic factors (e.g. OR 2.18, 95% CI 1.46-3.32), and significantly decreased for each 2-fold elevation in circulating PlGF (OR 0.50, 95% CI 0.30-0.82) between 7 and 26 weeks' gestation. Cross-sectional analysis of the angiogenic factors across gestation showed significant differences during the third trimester in women who develop preeclampsia compared with appropriate controls in all high-risk groups. However, when data were examined in relation to the gestational week when preeclampsia was diagnosed only sFlt1 was significantly higher 2 to 5 weeks before the clinical onset of preeclampsia and only in women with previous preeclampsia.

CONCLUSIONS:

The pattern of elevated concentrations of sFlt1 and sEng, and low PlGF in high-risk pregnant subjects who develop preeclampsia is similar to that reported in low-risk pregnant women. However, differences in these factors among high-risk women who do and do not develop preeclampsia are modest, and do not appear to be clinically useful predictors in these high-risk pregnant women.

• Authors: Robert W Powers, Arun Jeyabalan, Rebecca G Clifton, Peter Van Dorsten, John C Hauth, Mark A Klebanoff, Marshall D Lindheimer, Baha Sibai, Mark Landon, Menachem Miodovnik, Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network
• Journal: PloS one (PLoS One) Vol. 5 Issue 10 Pg. e13263 (Oct 11 2010) ISSN: 1932-6203 [Electronic] United States
• PMID: 20948996 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Angiogenesis Inducing Agents
• Antigens, CD
• ENG protein, human
• Endoglin
• PGF protein, human
• Pregnancy Proteins
• Receptors, Cell Surface
• Placenta Growth Factor
• Receptor, Macrophage Colony-Stimulating Factor

Topics

• Adult
• Angiogenesis Inducing Agents (blood)
• Antigens, CD (blood)
• Endoglin
• Female
• Humans
• Placenta Growth Factor
• Pre-Eclampsia (blood, diagnosis)
• Pregnancy
• Pregnancy Proteins (blood)
• Receptor, Macrophage Colony-Stimulating Factor (blood)
• Receptors, Cell Surface (blood)