title: Relationship between nulliparity and preeclampsia may be explained by altered circulating soluble fms-like tyrosine kinase 1.
abstract: OBJECTIVE
  To test the hypothesis that the risk of preeclampsia in nulliparous women may be due to an anti-angiogenic state.
  
  
  METHODS
  Maternal serum samples obtained in the third trimester from nulliparous (n = 86) and multiparous (n = 165) singleton uncomplicated pregnancies were analyzed for levels of angiogenic factors - soluble fms like tyrosine kinase 1 (sFlt1) and placental growth factor (PlGF) by enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  For nulliparous and multiparous pregnancies, serum sFlt1 levels were 12 732 ± 832 and 10 162 ± 666 (p = 0.020), serum PlGF levels were 215 ± 15 and 249 ± 14 (p = 0.093) (all reported as mean SD in pg/ml) and mean ratios of sFlt1/PlGF were 93 ± 12 and 62 ± 5 (p = 0.023), respectively. Adjustment for maternal age and fetal birth weight did not alter the results.
  
  
  CONCLUSIONS
  Nulliparous pregnancies had higher circulating sFlt1 levels and sFlt1/PlGF ratios than multiparous pregnancies, suggesting an association with an angiogenic imbalance. Taken together with the pathogenic role of anti-angiogenic factors in preeclampsia, our data may be one explanation for the epidemiological observation that nulliparity is a risk factor for the development of preeclampsia.
authors.affiliation: OB/GYN, Hadassah-Hebrew University Medical Center , Jerusalem , Israel and.
authors.forename: Yuval
authors.initials: Y
authors.lastname: Bdolah
authors.forename: Uriel
authors.initials: U
authors.lastname: Elchalal
authors.forename: Shira
authors.initials: S
authors.lastname: Natanson-Yaron
authors.forename: Hadas
authors.initials: H
authors.lastname: Yechiam
authors.forename: Tali
authors.initials: T
authors.lastname: Bdolah-Abram
authors.forename: Caryn
authors.initials: C
authors.lastname: Greenfield
authors.forename: Debra
authors.initials: D
authors.lastname: Goldman-Wohl
authors.forename: Ariel
authors.initials: A
authors.lastname: Milwidsky
authors.forename: Sarosh
authors.initials: S
authors.lastname: Rana
authors.forename: S Ananth
authors.initials: SA
authors.lastname: Karumanchi
authors.forename: Simcha
authors.initials: S
authors.lastname: Yagel
authors.forename: Drorith
authors.initials: D
authors.lastname: Hochner-Celnikier
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010298:Parity / Q000502:physiology*; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000097:blood* / Q000209:etiology; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood*; D011263:Pregnancy Trimester, Third / Q000097:blood; 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; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1