title: Smoking during pregnancy: changes in mid-gestation angiogenic factors in women at risk of developing preeclampsia according to uterine artery Doppler findings.
abstract: OBJECTIVE
  To ascertain whether angiogenic factors are altered in smokers at increased risk of preeclampsia (PE) according to uterine artery Doppler (UAD) assessment.
  
  
  METHODS
  Uterine artery mean pulsatility index (PI), maternal placental growth factor (PlGF), and soluble fms-like tyrosine kinase-1 (sFlt-1) serum levels were measured in 125 healthy pregnant women at 24 weeks of gestation. Smoking status was determined based on cotinine levels in maternal blood.
  
  
  RESULTS
  Smokers had significantly higher PlGF concentration compared with nonsmokers [median PlGF levels: 575 (511) vs. 277 (259) pg/mL, respectively, p = 0.001]. The differences in PlGF levels were also observed between smokers and nonsmokers within the group of women with abnormal UAD and therefore at high risk of developing PE [median PlGF levels: 472 (434) vs. 235 (169) pg/mL, respectively, p = 0.0005]. In our patient cohort, 16 women developed PE (12.8%), of whom only 3 were smokers [odds ratios (ORs): 0.49; 95% confidence interval (CI) (0.13-1.84)]. In patients who finally developed intrauterine growth restriction, the PlGF/sFlt-1 ratio was significantly higher in the group of smokers compared with that of nonsmokers [0.39 (0.28) vs. 0.13 (0.21), respectively, p = 0.0311].
  
  
  CONCLUSIONS
  The effect of smoking in reducing the risk of PE may be due to the increase of PlGF and PlGF/sFlt-1 ratio in maternal blood, even among women with abnormal UAD.
authors.affiliation: Department of Obstetrics, Fetal Medicine Unit, Hospital Vall d'Hebron, Universitat Autonòma de Barcelona, Passeig Vall d'Hebron 119-129, Barcelona, Spain.
authors.forename: Elisa
authors.initials: E
authors.lastname: Llurba
authors.forename: Olga
authors.initials: O
authors.lastname: Sánchez
authors.forename: Carmen
authors.initials: C
authors.lastname: Domínguez
authors.forename: Gemma
authors.initials: G
authors.lastname: Soro
authors.forename: Maria
authors.initials: M
authors.lastname: Goya
authors.forename: Jaume
authors.initials: J
authors.lastname: Alijotas-Reig
authors.forename: Lluís
authors.initials: L
authors.lastname: Cabero
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia; D011247:Pregnancy / Q000097:blood*; D011257:Pregnancy Proteins / Q000097:blood*; D012189:Retrospective Studies; D012907:Smoking / Q000097:blood*; D016216:Ultrasonography, Prenatal; D055988:Uterine Artery / Q000000981:diagnostic imaging; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*; D055815:Young Adult
chemical_list: C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor; D040281:Vascular Endothelial Growth Factor Receptor-1