title: Do anti-angiogenic or angiogenic factors contribute to the protection of birth weight at high altitude afforded by Andean ancestry?
abstract: OBJECTIVE
  This prospective study was designed to determine whether variation in angiogenic (placental growth factor [PlGF]) and/or anti-angiogenic (soluble fms-like tyrosine kinase [sFlt-1]) factors contribute to the protective effect of highland ancestry (Andean) from altitude-associated reductions in fetal growth.
  
  
  METHODS
  Plasma sFlt-1 and PlGF levels, uterine artery (UA) blood flow, and fetal biometry were determined in low-altitude (400 m; Andean n = 27, European n = 28) and high-altitude (3600 m; Andean n = 51, European n = 44) residents during pregnancy (20 and 36 weeks) and 4 months postpartum.
  
  
  RESULTS
  High-altitude decreased sFlt-1 levels in both groups, Andeans had lower sFlt-1, comparable PlGF, lower sFlt-1/PlGF ratios, and higher UA blood flow throughout pregnancy relative to Europeans. Altitude decreased birth weight in Europeans but not Andeans. In high-altitude Europeans sFlt-1/PlGF and sFlt-1 levels were negatively associated with UA diameter and birth weight, respectively.
  
  
  CONCLUSIONS
  Lower sFlt-1 and sFlt-1/PLGF ratio may contribute to or result from variations in maternal vascular adaptation to pregnancy between Andean and Europeans at high altitude. Subsequently, these effects could potentially influence ancestry-associated differences in birth weight.
authors.affiliation: Altitude Research Center, University of Colorado-Denver, Aurora, CO 80045, USA. daniela.davila@ucdenver.edu
authors.forename: R Daniela
authors.initials: RD
authors.lastname: Dávila
authors.forename: Colleen G
authors.initials: CG
authors.lastname: Julian
authors.forename: Megan J
authors.initials: MJ
authors.lastname: Wilson
authors.forename: Vaughn A
authors.initials: VA
authors.lastname: Browne
authors.forename: Carmelo
authors.initials: C
authors.lastname: Rodriguez
authors.forename: Abigail W
authors.initials: AW
authors.lastname: Bigham
authors.forename: Mark D
authors.initials: MD
authors.lastname: Shriver
authors.forename: Enrique
authors.initials: E
authors.lastname: Vargas
authors.forename: Lorna G
authors.initials: LG
authors.lastname: Moore
mesh_terms: D000064:Acclimatization / Q000235:genetics*; D000328:Adult; D000531:Altitude; D044467:American Indian or Alaska Native / Q000235:genetics*; D042501:Angiogenic Proteins / Q000097:blood*; D043165:Angiostatic Proteins / Q000097:blood*; D001724:Birth Weight / Q000235:genetics*; D001838:Bolivia; D016009:Chi-Square Distribution; D005260:Female; D047109:Fetal Development / Q000235:genetics; D005317:Fetal Growth Retardation / Q000097:blood / Q000235:genetics / Q000503:physiopathology / Q000517:prevention & control*; D020022:Genetic Predisposition to Disease; D005865:Gestational Age; D006801:Humans; D010375:Pedigree; D000072483:Placenta Growth Factor; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood; D011446:Prospective Studies; D012039:Regional Blood Flow; D018570:Risk Assessment; D012307:Risk Factors; D055988:Uterine Artery / Q000503:physiopathology; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood; D044465:White People / Q000235:genetics*; D055815:Young Adult
chemical_list: D042501:Angiogenic Proteins; D043165:Angiostatic Proteins; C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1