title: The association of body mass index with serum angiogenic markers in normal and abnormal pregnancies.
abstract: OBJECTIVE
  Because obesity is a risk factor for placental dysfunction, we hypothesized that maternal body mass index (BMI) would be associated with alterations in serum angiogenic markers.
  
  
  METHODS
  We included 2399 singleton pregnancies with and without placental dysfunction in a prospective longitudinal cohort study of angiogenic markers. We modeled the relationship between categorical and continuous BMI, soluble fms-like tyrosine kinase-1 (sFlt-1), and placental growth factor (PlGF) over gestation, stratified by pregnancy outcome.
  
  
  RESULTS
  In women with normal pregnancies, a higher BMI was associated with lower sFlt-1 values across gestation (P < .0001), lower PlGF in the second and third trimesters (P < .0001), and lower rate of change in PlGF (P < .0001). Similar relationships were seen between maternal BMI, sFlt-1 (P < .0001), and PlGF (P = .0005) in women with clinically evident placental dysfunction.
  
  
  CONCLUSIONS
  The sFlt-1 value is inversely associated with maternal BMI. The pattern of change in PlGF is also dependent on maternal BMI, indicating that obese women may have abnormalities in angiogenesis near term.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: czera@partners.org.
authors.forename: Chloe A
authors.initials: CA
authors.lastname: Zera
authors.affiliation: Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Seely
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
authors.forename: Louise E
authors.initials: LE
authors.lastname: Wilkins-Haug
authors.affiliation: Harvard Medical School, Boston, MA; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel-Deaconess Medical Center, Boston, MA.
authors.forename: Kee-Hak
authors.initials: KH
authors.lastname: Lim
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA.
authors.forename: Samuel I
authors.initials: SI
authors.lastname: Parry
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: McElrath
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D009765:Obesity / Q000097:blood / Q000503:physiopathology; D000072483:Placenta Growth Factor; D011247:Pregnancy / Q000097:blood*; D011248:Pregnancy Complications / Q000097:blood*; D011257:Pregnancy Proteins / Q000097:blood*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*
chemical_list: C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1
keywords: angiogenic markers; obesity; placenta; preeclampsia; soluble fms-like tyrosine kinase-1