title: Obstetric antiphospholipid syndrome: early variations of angiogenic factors are associated with adverse outcomes.
abstract: The prognostic value of angiogenic factors in newly pregnant women with obstetric antiphospholipid syndrome (oAPS) has not been documented. We observed 513 oAPS who experienced three consecutive spontaneous abortions before the 10thweek of gestation or one fetal loss at or beyond the 10thweek. We assessed the plasma concentrations of the proangiogenic factor placenta growth factor (PIGF) and of the antiangiogenic factor soluble fms-like tyrosine kinase-1 on the eve and on the 4thday of the low-molecular weight heparin-low-dose aspirin treatment. Placenta growth factor and fms-like tyrosine kinase-1 plasma concentrations showed marked increases. Treatment-associated variations of PIGF and of soluble fms-like tyrosine kinase-1 were antagonist risk factors for placenta-mediated complications (PMC) and for severe PMC, for fetal death, stillbirth and neonatal death. The ratio between PIGF increase and soluble fms-like tyrosine kinase-1 was a summary variable whose best cut-off values (1.944.10-2) had high negative predictive values for PMC (0.918) and may be used to help rule out the development of PMC in evolutive pregnancies after 19 completed weeks. The early variations of PIGF and soluble fms-like tyrosine kinase-1 concentrations in newly pregnant oAPS may help to detect patients at low risk of PMC. (clinicaltrials.gov identifier: 02855047).
authors.affiliation: Department of Hematology, University Hospital, Nîmes, France.|Research team UPRES EA2992 "Caractéristiques féminines des dysfonctions des interfaces vasculaires CaFe-DIVa", University of Montpellier, France.
authors.forename: Éva
authors.initials: É
authors.lastname: Cochery-Nouvellon
authors.affiliation: Department of Hematology, University Hospital, Nîmes, France.|Research team UPRES EA2992 "Caractéristiques féminines des dysfonctions des interfaces vasculaires CaFe-DIVa", University of Montpellier, France.|Laboratory of Hematology, Faculty of Pharmacy and Biological Sciences, University of Montpellier, France.
authors.forename: Érick
authors.initials: É
authors.lastname: Mercier
authors.affiliation: Department of Hematology, University Hospital, Nîmes, France.|Research team UPRES EA2992 "Caractéristiques féminines des dysfonctions des interfaces vasculaires CaFe-DIVa", University of Montpellier, France.|Laboratory of Hematology, Faculty of Pharmacy and Biological Sciences, University of Montpellier, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Bouvier
authors.affiliation: Department of Internal Medicine, University Hospital, Nîmes, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Balducchi
authors.affiliation: Research team UPRES EA2992 "Caractéristiques féminines des dysfonctions des interfaces vasculaires CaFe-DIVa", University of Montpellier, France.|Department of Vascular Medicine and Internal Medicine, University Hospital, Montpellier, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Quéré
authors.affiliation: Research team UPRES EA2992 "Caractéristiques féminines des dysfonctions des interfaces vasculaires CaFe-DIVa", University of Montpellier, France.|Department of Vascular Medicine, University Hospital, Nîmes, France.
authors.forename: Antonia
authors.initials: A
authors.lastname: Perez-Martin
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital, Nîmes, France.
authors.forename: Eve
authors.initials: E
authors.lastname: Mousty
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital, Nîmes, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Letouzey
authors.affiliation: Department of Hematology, University Hospital, Nîmes, France jean.christophe.gris@chu-nimes.fr.|Research team UPRES EA2992 "Caractéristiques féminines des dysfonctions des interfaces vasculaires CaFe-DIVa", University of Montpellier, France.|Laboratory of Hematology, Faculty of Pharmacy and Biological Sciences, University of Montpellier, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Gris
mesh_terms: D000293:Adolescent; D000328:Adult; D016736:Antiphospholipid Syndrome / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy; D001241:Aspirin / Q000627:therapeutic use; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D008565:Membrane Proteins / Q000097:blood*; D010920:Placenta / Q000378:metabolism; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First / Q000097:blood*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D008565:Membrane Proteins; C098069:PIGF protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1; D001241:Aspirin