title: Mid-pregnancy levels of angiogenic markers as indicators of pathways to preterm delivery.
abstract: OBJECTIVE
  To determine whether mid-pregnancy levels of angiogenic markers were associated with increased risk of preterm delivery (PTD).
  
  
  METHODS
  We studied a subcohort from the Pregnancy Outcomes and Community Health Study for whom mid-pregnancy angiogenic markers (soluble fms-like tyrosine kinase-1 [sFlt-1], soluble endoglin [sEng] and placental growth factor [PlGF]) and covariate data were available (N = 1301). Angiogenic marker levels were grouped as high/not high (sFlt-1 and sEng), low/not low (PlGF) and high/intermediate/low (sFlt-1). Associations between levels of angiogenic markers and PTD/PTD subtype were determined for women who were nonsmokers during pregnancy (N = 933).
  
  
  RESULTS
  Low PlGF and high sEng were associated with medically-indicated PTD and PTD <35 weeks, largely due to preeclampsia (PE). Excluding PE and small-for-gestational-age infants, low sFlt-1 was positively associated with medically-indicated PTD.
  
  
  CONCLUSIONS
  Among nonsmokers, mid-pregnancy levels of angiogenic markers may mark multiple pathways leading to PTD, only one attributable to PE.
authors.affiliation: Department of Epidemiology, Michigan State University, East Lansing, MI 48824, USA.
authors.forename: Renée S
authors.initials: RS
authors.lastname: Mijal
authors.forename: Claudia B
authors.initials: CB
authors.lastname: Holzman
authors.forename: Sarosh
authors.initials: S
authors.lastname: Rana
authors.forename: S Ananth
authors.initials: SA
authors.lastname: Karumanchi
authors.forename: Jianling
authors.initials: J
authors.lastname: Wang
authors.forename: Alla
authors.initials: A
authors.lastname: Sikorskii
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D000071063:Endoglin; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D018919:Neovascularization, Physiologic; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000097:blood; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood*; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000097:blood*; D011956:Receptors, Cell Surface / Q000097:blood*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*; D055815:Young Adult
chemical_list: D015703:Antigens, CD; D015415:Biomarkers; C064206:ENG protein, human; D000071063:Endoglin; C000608036:PGF protein, human; D011257:Pregnancy Proteins; D011956:Receptors, Cell Surface; D000072483:Placenta Growth Factor; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1