title: Maternal hemoglobin concentration and hematocrit values may affect fetus development by influencing placental angiogenesis.
abstract: OBJECTIVE
  Vasculogenesis and angiogenesis are crucial for maintaining proper placental perfusion and optimal fetal development. Among other physical and chemical factors, hypoxia is known to stimulate angiogenic processes. Preplacental type of hypoxia is often associated with maternal anemia and is thought to enhance vascularization within the fetoplacental unit. The goal of this study was to establish the correlation between the local expression of vascular endothelial growth factor (VEGF) and placenta growth factor (PlGF) receptors (flt-1, flk-1) with maternal hemoglobin (Hb) concentration, hematocrit (Ht) values and the infant birthweight.
  
  
  METHODS
  In total, 43 specimens of term placentas obtained from normal course pregnancies delivered at term were included in the study. The expression of flt-1 and flk-1 receptors was analyzed by immunohistochemical staining. Vascular/extravascular tissular index (V/EVTI) was measured by assessing a total vascular area. Nonparametric Mann-Whitney U-test and Spearman's rank correlation were used to compare the various parameters and their differences between the groups.
  
  
  RESULTS
  Among the patients with low Hb concentration, nearly 2-fold greater expression of the flt-1 receptor was positively correlated with infants birthweight (p = 0.028).
  
  
  CONCLUSIONS
  Increased placental vascular density (increased flt-1 expression), during a physiological course of gestation, may be an adaptive response to lowered maternal Hb concentration and Ht values encountered during pregnancy.
authors.affiliation: a Chair and Department of General and Experimental Pathology with Centre for Preclinical Research and Technology , Medical University of Warsaw , Warszawa , Poland and.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Stangret
authors.affiliation: b Chair and Department of Obstetrics, Gynecology, and Oncology , 2nd Faculty of Medical University of Warsaw , Warszawa , Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Wnuk
authors.affiliation: a Chair and Department of General and Experimental Pathology with Centre for Preclinical Research and Technology , Medical University of Warsaw , Warszawa , Poland and.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Szewczyk
authors.affiliation: a Chair and Department of General and Experimental Pathology with Centre for Preclinical Research and Technology , Medical University of Warsaw , Warszawa , Poland and.
authors.forename: Michał
authors.initials: M
authors.lastname: Pyzlak
authors.affiliation: a Chair and Department of General and Experimental Pathology with Centre for Preclinical Research and Technology , Medical University of Warsaw , Warszawa , Poland and.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Szukiewicz
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D005260:Female; D047109:Fetal Development; D005317:Fetal Growth Retardation / Q000378:metabolism*; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D018919:Neovascularization, Physiologic; D010920:Placenta / Q000098:blood supply*; D000072483:Placenta Growth Factor / Q000378:metabolism; D011247:Pregnancy; D018709:Statistics, Nonparametric; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D055815:Young Adult
chemical_list: D006454:Hemoglobins; D042461:Vascular Endothelial Growth Factor A; D000072483:Placenta Growth Factor
keywords: Anemia; angiogenesis; hypoxia; placenta; placental growth factor; vascular endothelial growth factor