title: Human chorionic gonadotropin, angiogenic factors, and preeclampsia risk: a nested case-control study.
abstract: OBJECTIVE
  To study whether human chorionic gonadotropin concentrations during pregnancy or combinations of human chorionic gonadotropin and other angiogenic factors, soluble fms-like tyrosine kinase 1 and placental growth factor (PlGF), are associated with preeclampsia risk.
  
  
  METHODS
  Nested case-control study.
  
  
  METHODS
  Population cohort of pregnant women.
  
  
  METHODS
  A total of 121 cases of preterm (<37 weeks) and 158 cases of term preeclampsia (≥37 weeks of gestation) and 356 women without preeclampsia (controls).
  
  
  METHODS
  Women with preeclampsia were identified by linkage to the Medical Birth Registry of Norway. Concentrations of human chorionic gonadotropin, soluble fms-like tyrosine kinase 1 and PlGF were measured in maternal serum samples collected in each trimester of pregnancy.
  
  
  METHODS
  Odds ratios of preterm and term preeclampsia.
  
  
  RESULTS
  High human chorionic gonadotropin concentrations (highest quartile) in the first trimester were associated with reduced risk for preterm preeclampsia (OR 0.3, 95% CI 0.1-0.9), compared with low human chorionic gonadotropin (lowest quartile), whereas high human chorionic gonadotropin concentrations in the second trimester were associated with increased risk for preterm preeclampsia (OR 4.0, 95% CI 1.8-8.9). High human chorionic gonadotropin concentrations in the third trimester were associated with increased risk for term preeclampsia (OR 4.8, 95% CI 1.8-13.3). Concentrations of human chorionic gonadotropin above the median value combined with PlGF below the median in the second trimester were associated with very high risk for preterm preeclampsia (OR 36.9, 95% CI 8.2-165.8).
  
  
  CONCLUSIONS
  The results suggest an important role of human chorionic gonadotropin in the pathophysiological processes that lead to preeclampsia. The combined association of human chorionic gonadotropin and PlGF indicates a possible synergism between underlying biological pathways.
authors.affiliation: Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Endocrinology, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Bjørn O
authors.initials: BO
authors.lastname: Asvold
authors.forename: Anne
authors.initials: A
authors.lastname: Eskild
authors.forename: Lars J
authors.initials: LJ
authors.lastname: Vatten
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D005865:Gestational Age; D006801:Humans; D009664:Norway / Q000453:epidemiology; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000097:blood* / Q000453:epidemiology*; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood*; D011264:Pregnancy Trimesters; D047928:Premature Birth / Q000097:blood / Q000453:epidemiology; D012307:Risk Factors; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006063:Chorionic Gonadotropin; C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1
keywords: Human chorionic gonadotropin; angiogenesis; hypertension in pregnancy; placental growth factor; preeclampsia; soluble fms-like tyrosine kinase 1