Sequential Changes in Antiangiogenic Factors in Early Pregnancy and Risk of Developing Preeclampsia

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 2007-07, Vol.50 (1), p.137-142
• Main Authors: Rana, Sarosh, Karumanchi, S Ananth, Levine, Richard J, Venkatesha, Shivalingappa, Rauh-Hain, Jose Alejandro, Tamez, Hector, Thadhani, Ravi
• Format: Article
• Language: English
• Subjects: Adult; Algorithms; Angiogenesis Inhibitors - blood; Antigens, CD - blood; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Case-Control Studies; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Diseases of mother, fetus and pregnancy; Endoglin; Female; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Pre-Eclampsia - etiology; Predictive Value of Tests; Pregnancy; Pregnancy Trimester, First - blood; Pregnancy Trimester, Second - blood; Pregnancy. Fetus. Placenta; Receptors, Cell Surface - blood; Risk Factors; Vascular Endothelial Growth Factor Receptor-1 - blood
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/HYPERTENSIONAHA.107.087700

Concentrations of soluble fms-like tyrosine kinase 1 (sFlt1) and soluble endoglin (sEng) increase in maternal blood with the approach of clinical preeclampsia. Although alterations in these circulating antiangiogenic factors herald the signs and symptoms of preeclampsia, in vitro studies suggest they may also play a role in regulating early placental cytotrophoblast functions. Early pregnancy changes in sFlt1 and sEng may thus identify women destined to develop preeclampsia. We performed a nested case-control study of 39 women who developed preeclampsia and 147 contemporaneous normotensive controls each with serum collected in the first (11 to 13 weeks of gestation) and second (17 to 20 weeks) trimesters. Whereas levels of sFlt1 and sEng at 11 to 13 weeks were similar between cases and controls (sFlt13.5±0.3 ng/mL versus 3.0±0.1, P=0.14; sEng 6.9±0.3 ng/mL versus 6.6±0.2, P=0.37, respectively), at 17 to 20 weeks both were elevated in the women destined to develop preeclampsia (sFlt14.1±0.5 ng/mL versus 3.1±0.1, P