title: Gestational angiogenic biomarker patterns in high risk preeclampsia groups.
abstract: OBJECTIVE
  Several conditions are associated with increased preeclampsia (PE) risk. Whether altered maternal angiogenic factor levels contribute to risk in these conditions is unknown. Our objective was to compare angiogenic biomarker patterns in high-risk pregnancies and low-risk controls.
  
  
  METHODS
  We conducted a planned secondary analysis of a 2-center observational study of angiogenic biomarkers in high-risk women. A total of 156 pregnant women with a PE risk factor and 59 low-risk controls were studied. Serial maternal serum samples were collected during 3 gestational windows: 23-27 weeks, 28-31 weeks, and 32-35 weeks. Soluble fms-like tyrosine kinase 1 (sFlt1), soluble endoglin (sEng), and placental growth factor (PlGF) were measured by enzyme-linked immunosorbent assay. Geometric mean angiogenic biomarker levels and angiogenic ratio (sFlt1 + sEng):PlGF were compared with low-risk controls for each risk group, at each gestational window.
  
  
  RESULTS
  Gestational biomarker patterns differed in PE risk groups as compared with low-risk controls. Women with multiple gestations had markedly higher sFlt1 and sEng at all gestational windows. Women with prior PE had higher sFlt1 and angiogenic ratio, and lower PlGF, from 28 weeks onward. Women with chronic hypertension had significantly higher angiogenic ratio for all 3 gestational windows, but differences disappeared when women with PE were excluded. Obese and nulliparous women had significantly lower PlGF, but no differences in the angiogenic ratio.
  
  
  CONCLUSIONS
  High-risk groups have altered angiogenic biomarker patterns compared with controls, suggesting that altered production or metabolism of these factors may contribute to PE risk, particularly in women with multiple gestations and prior PE.
authors.affiliation: Department of Medicine, Division of Nephrology, George Washington University School of Medicine and Health Sciences, Washington, DC; Division of Nephrology, Department of Medicine, Lehigh Valley Health Network, Allentown, PA.
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Maynard
authors.forename: Sybil L
authors.initials: SL
authors.lastname: Crawford
authors.forename: Susanne
authors.initials: S
authors.lastname: Bathgate
authors.forename: Jing
authors.initials: J
authors.lastname: Yan
authors.forename: Laura
authors.initials: L
authors.lastname: Robidoux
authors.forename: Melissa
authors.initials: M
authors.lastname: Moore
authors.forename: Tiffany A
authors.initials: TA
authors.lastname: Moore Simas
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D043925:Angiogenesis Inducing Agents / Q000097:blood*; D015703:Antigens, CD / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D000071063:Endoglin; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D016014:Linear Models; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood*; D018566:Pregnancy, High-Risk / Q000097:blood*; D011956:Receptors, Cell Surface / Q000097:blood*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*
chemical_list: D043925:Angiogenesis Inducing Agents; 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; D040281:Vascular Endothelial Growth Factor Receptor-1
keywords: PlGF; angiogenic factors; preeclampsia; sEng; sFlt1