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Infant size and the association between maternal circulating angiogenic factors and preeclampsia

Journal of Perinatology volume 38, pages 456–461 (2018)Cite this article

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Abstract

Objective:

To assess the effect of infant size as a marker of placental function on the association between preeclampsia and the ratio of soluble fms-like tyrosine kinase 1 (sFlt-1) to placental growth factor (PlGF).

Study design:

The angiogenic factors sFlt-1 and PlGF were measured prospectively at 26 weeks gestation in 2322 women. Pregnancies were stratified by whether or not they were complicated by preeclampsia, the timing of delivery, and birthweight Z-score.

Result:

Independent of preeclampsia status, women with small infants (Z < -1.0) have an increased sFlt-1/PlGF ratio, and women with large infants (Z > 1.0) have a decreased ratio. Among pregnancies yielding small infants, the sFlt-1/PlGF ratio is markedly elevated in preeclamptic pregnancies requiring delivery before 37 weeks (110.0 vs. 17.9, p < 0.0001) but not in preeclamptic pregnancies delivered at term. The strength of the association between preeclampsia and the sFlt-1/PlGF ratio is increased for small infants compared to normal-sized or large infants.

Conclusion:

The sFlt-1/PlGF ratio in the late second trimester is similarly elevated in women with preeclampsia and in women with small infant size and more markedly elevated in a syndrome of placental dysfunction characterized by preeclampsia, preterm delivery, and growth restriction.

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Acknowledgements

This research was supported by an unrestricted grant from Abbott Diagnostics Division (9MZ-04-06N03).

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Authors and Affiliations

  1. Division of Cardiology, Massachusetts General Hospital, Boston, MA, USA

    Michael C. Honigberg

  2. Harvard Medical School, Boston, MA, USA

    Michael C. Honigberg, Ellen W. Seely, Ann M. Thomas, Kee-Hak Lim & Thomas F. McElrath

  3. Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, MA, USA

    Ellen W. Seely

  4. Division of Maternal-Fetal Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Ann M. Thomas & Thomas F. McElrath

  5. Division of Maternal-Fetal Medicine, Beth Israel Deaconess Medical Center, Boston, USA

    Kee-Hak Lim

  6. Division of Maternal-Fetal Medicine, Hospital of the University of Pennsylvania, Pennsylvania, PA, USA

    Samuel Parry

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  1. Michael C. Honigberg
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Correspondence to Michael C. Honigberg.

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Honigberg, M.C., Seely, E.W., Thomas, A.M. et al. Infant size and the association between maternal circulating angiogenic factors and preeclampsia. J Perinatol 38, 456–461 (2018). https://doi.org/10.1038/s41372-018-0074-2

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