title: Evaluation of biochemical markers combined with uterine artery Doppler parameters in fetuses with growth restriction: a case-control study.
abstract: Assessing the biochemical markers levels and the uterine artery Doppler (UtA) parameters in fetuses with growth restriction (FGR).
  
  
  
  Prospective case-control study included 66 patients with diagnosis of FGR and 64 healthy pregnancies at 24-41 weeks of gestation. For both groups, maternal circulating concentrations of biochemical factors of soluble fms-like tyrosine kinase-1 (sFlt-1), soluble endoglin(sEng), adiponectin, A disintegrin and metalloproteinases (ADAM-12), pregnancy-associated plasma protein-A (PAPP-A), angiopoietin-2 (ANGI-2), vascular endothelial growth factor (VEGF) and transforming growth factor-β (TGF-β) were assayed by ELISA and UtA by Doppler were performed. ANOVA, Mann-Whitney tests and Pearson correlation coefficient were applied to compare the biochemical factors, UtA Doppler and EFW Z-score between the groups.
  
  
  
  Concentrations of sFlt-1, sEng, PAPP-A were significantly higher in FGR than controls (p < 0.0001, p = 0.02 and p = 0.03, respectively), but concentration of ANGI-2 (p < 0.0001) was significantly lower in FGR than controls and ADAM-12 levels had a tendency to be lower in the FGR, though not statistically significant (p = 0.059). Increased sEng concentrations were correlated with abnormal UtA Doppler in FGR.
  
  
  
  Fetal growth restriction fetuses showed increased serum levels of sFlt-1, sEng and PAPP-A with levels of ANGI-2 decreased and a positive association between elevated concentrations of sEng and changing impedance of UtA Doppler were observed.
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156, apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil.
authors.forename: Ana Cristina Perez
authors.initials: AC
authors.lastname: Zamarian
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156, apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil. araujojred@terra.com.br.
authors.forename: Edward
authors.initials: E
authors.lastname: Araujo Júnior
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156, apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil.
authors.forename: Sílvia
authors.initials: S
authors.lastname: Daher
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156, apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil.
authors.forename: Liliam Cristine
authors.initials: LC
authors.lastname: Rolo
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156, apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil.
authors.forename: Antonio Fernandes
authors.initials: AF
authors.lastname: Moron
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156, apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil.
authors.forename: Luciano Marcondes Machado
authors.initials: LM
authors.lastname: Nardozza
mesh_terms: D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood*; D005333:Fetus / Q000737:chemistry; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D055988:Uterine Artery / Q000000981:diagnostic imaging*
chemical_list: D015415:Biomarkers
keywords: Biochemical factors; Doppler ultrasound; Fetal growth restriction; Placenta; Soluble endoglin; Uterine artery