Soluble fms-Like Tyrosine Kinase 1 (sFlt1), Endoglin and Placental Growth Factor (PlGF) in Preeclampsia among High Risk Pregnancies

• Published in: PloS one Vol. 5; no. 10; p. e13263
• Main Authors: Powers, Robert W., Jeyabalan, Arun, Clifton, Rebecca G., Van Dorsten, Peter, Hauth, John C., Klebanoff, Mark A., Lindheimer, Marshall D., Sibai, Baha, Landon, Mark, Miodovnik, Menachem
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 11.10.2010; Public Library of Science (PLoS)
• Subjects: Adult; Angiogenesis; Angiogenesis Inducing Agents - blood; Antiangiogenics; Antigens, CD - blood; Aspirin; Blood pressure; Change detection; Childrens health; Diabetes; Diabetes mellitus; Endocrinology; Endoglin; Female; Fetuses; Gestation; Gestational diabetes; Gynecology; Humans; Hypertension; Medical records; Medicine; Obstetrics; Obstetrics/Hypertensive Disorders; Obstetrics/Management of High-Risk Pregnancies; Obstetrics/Pregnancy; Pathogenesis; Placenta; Placenta Growth Factor; Pre-eclampsia; Pre-Eclampsia - blood; Pre-Eclampsia - diagnosis; Preeclampsia; Pregnancy; Pregnancy Proteins - blood; Protein-tyrosine kinase; Proteins; Receptor, Macrophage Colony-Stimulating Factor - blood; Receptors, Cell Surface - blood; Risk factors; Risk groups; Risk management; Secondary analysis; Studies; Tyrosine; Vascular endothelial growth factor; Womens health; Ohio; Pittsburgh Pennsylvania; United States > US; Pennsylvania
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0013263

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. 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. 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. 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.