title: Maternal serum placental growth factor at 11-13 weeks' gestation and fetal cardiac defects.
abstract: OBJECTIVE
  To investigate the relationship between fetal heart defects and maternal serum placental growth factor (PlGF), a marker of placental angiogenesis.
  
  
  METHODS
  Maternal serum PlGF, pregnancy-associated plasma protein-A (PAPP-A) and uterine artery pulsatility index (UtA-PI) at 11-13 weeks' gestation were compared in 68 cases of isolated fetal major heart defects and 340 normal controls. Variables were converted into multiples of the median (MoM) after adjustment for gestational age, maternal age, racial origin, weight, parity and method of conception, and then compared between groups. The cardiac defects included 11 cases of obstruction of the left ventricular outflow tract (LVOT), 25 conotruncal abnormalities and 32 valve defects.
  
  
  RESULTS
  The median PlGF-MoM in the heart defect group was lower than in controls (0.80 (interquartile range (IQR), 0.57-1.08) vs 1.00 (IQR, 0.79-1.32); P < 0.0001). Low PlGF levels were observed in the presence of conotruncal and valve defects but not in the presence of LVOT defects. There was no significant difference between the group with fetal heart defects and controls in PAPP-A-MoM (0.95 (IQR, 0.68-1.28) vs 1.01 (IQR, 0.70-1.39); P = 0.292) or UtA-PI-MoM (1.01 (IQR, 0.84-1.28) vs 0.99 (IQR, 0.80-1.20); P = 0.396).
  
  
  CONCLUSIONS
  In pregnancies with isolated fetal heart defects there is evidence of impaired placental angiogenesis in the absence of impaired placental perfusion and function.
authors.affiliation: Department of Obstetrics, Maternal-Fetal Medicine Unit, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain. ellurba@vhebron.net
authors.forename: E
authors.initials: E
authors.lastname: Llurba
authors.forename: A
authors.initials: A
authors.lastname: Syngelaki
authors.forename: O
authors.initials: O
authors.lastname: Sánchez
authors.forename: E
authors.initials: E
authors.lastname: Carreras
authors.forename: L
authors.initials: L
authors.lastname: Cabero
authors.forename: K H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005318:Fetal Heart / Q000002:abnormalities*; D006801:Humans; D018919:Neovascularization, Physiologic / Q000502:physiology; D010920:Placenta / Q000098:blood supply; D000072483:Placenta Growth Factor; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000378:metabolism*; D011261:Pregnancy Trimester, First / Q000097:blood*; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000502:physiology; D055988:Uterine Artery / Q000502:physiology
chemical_list: C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor; D011266:Pregnancy-Associated Plasma Protein-A