title: Circulating angiogenic factors are related to the severity of gestational hypertension and preeclampsia, and their adverse outcomes.
abstract: Gestational hypertension (GH) and preeclampsia (PE) are characterized by an imbalance in angiogenic factors. However, the relationship among these factors with the severity of hypertensive disorders of pregnancy (HDP) and adverse outcomes are not fully elucidated. We examined whether these biomarkers are related with the severity of HDP and adverse outcomes.Using a cross-sectional design, serum concentrations of placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), and soluble endoglin were determined in 764 pregnant women: 75 healthy pregnant, 83 with mild GH (mGH), 105 with severe GH (sGH), 122 with mild PE (mPE), and 379 with severe PE (sPE).All angiogenic factors' concentrations were significantly different (P ≤ 0.041) in HDP than in healthy pregnancy. In addition, these factors were markedly different in sPE than in mPE, sGH, or mGH (P ≤ 0.027) and in patients with sGH that in those with mPE or mGH (P < 0.05). As compared to mGH and mPE, patients with sGH and sPE had higher rates of both preterm delivery at <34 weeks of gestation and small-for-gestational age infants. Moreover, patients with sPE had higher rates of adverse maternal outcomes (P < 0.001) when compared to patients with mGH, sGH, or mPE. In all cases, levels of sFlt-1/PlGF ratio were significantly higher in patients with sGH and sPE who had adverse perinatal and maternal outcomes than in those with sGH and sPE who did not (P ≤ 0.016).Circulating concentrations of angiogenic factors appear to be suitable markers to assess the severity of GH and PE, and adverse outcomes.
authors.affiliation: Medical Research Unit in Reproductive Medicine, UMAE-Hospital de Ginecología y Obstetricia "Luis Castelazo Ayala," Instituto Mexicano del Seguro Social Division of Maternal-Fetal Medicine, UMAE-Hospital de Ginecología y Obstetricia "Luis Castelazo Ayala," Instituto Mexicano del Seguro Social Department of Obstetrics and Gynecology, Hospital General Regional No. 251 Metepec, Instituto Mexicano del Seguro Social Research Unit in Thrombosis, Hemostasis, and Atherogenesis, Hospital Gabriel Mancera, Instituto Mexicano del Seguro Social, México, D.F., México.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Leaños-Miranda
authors.forename: Francisco
authors.initials: F
authors.lastname: Méndez-Aguilar
authors.forename: Karla Leticia
authors.initials: KL
authors.lastname: Ramírez-Valenzuela
authors.forename: Marilyn
authors.initials: M
authors.lastname: Serrano-Rodríguez
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Berumen-Lechuga
authors.forename: Carlos José
authors.initials: CJ
authors.lastname: Molina-Pérez
authors.forename: Irma
authors.initials: I
authors.lastname: Isordia-Salas
authors.forename: Inova
authors.initials: I
authors.lastname: Campos-Galicia
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D000071063:Endoglin / Q000097:blood*; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D000072483:Placenta Growth Factor / Q000097:blood*; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D047928:Premature Birth / Q000097:blood*; D012720:Severity of Illness Index; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*; D055815:Young Adult
chemical_list: C064206:ENG protein, human; D000071063:Endoglin; D000072483:Placenta Growth Factor; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1