Biomarkers of endothelial dysfunction in preeclampsia and neonatal morbidity: a case-control study.
OBJECTIVE
To investigate the association of preeclampsia with angiogenic imbalance, and the correlation of levels of angiogenic and anti-angiogenic factors to complications in mother and fetus.


METHODS
Serum samples were obtained from 40 women with established preeclampsia (study group) and from 40 normotensive women (control group). Epidemiological characteristics of the two groups were analyzed. The levels of the angiogenic (VEGF and PlGF) and anti-angiogenic (sFlt-1) factors of the two study groups were determined in serum using ELISA. Neonatal adverse outcomes (late preterm, early term, low birth weight (LBW), very LBW (VLBW), intrauterine growth restriction (IUGR), and neonatal intensive care unit (NICU) admission) between the groups of the study were analyzed, as well as the association between the biomarkers of the study and neonatal adverse outcomes of the preeclamptic group of patients.


RESULTS
sFlt-1 levels were significantly higher in the preeclamptic women compared to normotensive women (median (range): 21297 (690-32637)pg/ml vs. 846.45 (363-2867)pg/ml, respectively), whereas there was a significant decrease in the levels of VEGF (90 (90-211)pg/ml vs. 90.55 (90-521)pg/ml, respectively), as well as in the levels of PlGF (13.62 (8-532)pg/ml vs. 239.86 (61-685)pg/ml, respectively). The increased serum values of the anti-angiogenic sFlt-1 were associated with increased rates of late preterm and early term births and VLBW.


CONCLUSIONS
An imbalance between angiogenic and anti-angiogenic factors exists in preeclampsia and is associated with adverse maternal and neonatal outcomes.
4th Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Greece. Electronic address: masourasophia@yahoo.gr.
Sophia
S
Masoura
4th Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Greece.
Ioannis
I
Kalogiannidis
Laboratory of Biological Chemistry, Faculty of Medicine, Aristotle University of Thessaloniki, Greece.
Kali
K
Makedou
1st Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Greece.
Theodoros
T
Theodoridis
3rd Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Greece.
Katerina
K
Koiou
Laboratories "Analysis", Thessaloniki, Greece.
Spiros
S
Gerou
1st Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Greece.
Apostolos
A
Athanasiadis
4th Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Greece.
Theodoros
T
Agorastos
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood*; D016015:Logistic Models; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000097:blood* / Q000503:physiopathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011257:Pregnancy Proteins / Q000097:blood*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*; D055815:Young Adult
D015415:Biomarkers; C000608036:PGF protein, human; D011257:Pregnancy Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000072483:Placenta Growth Factor; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1
PlGF; Preeclampsia; VEGF; sFlt-1