First trimester serum angiogenic/anti-angiogenic status in twin pregnancies: relationship with assisted reproduction technology

Sánchez, Olga; Llurba, Elisa; Marsal, G.; Domı́nguez, Carmen; Aulesa, C; Sánchez‐Durán, María Ángeles; Goya, María; Alijotas‐Reig, Jaume; Carreras, Elena; Cabero, L.

doi:10.1093/humrep/der394

Cited by 25 publications

(38 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We found that the PAPP-A and PlGF MoM levels were higher in women with a twin pregnancy than in those with a singleton pregnancy. These findings are consistent with those of previous studies [3637]. It has been reported that PlGF levels are lower in women with twin pregnancies who have PE, and the PAPP-A levels increase by the same magnitude that the PlGF levels reduce, which is considered to result from placental over-compensation [3738].…”

Section: Discussionsupporting

confidence: 92%

Maternal serum placental growth factor and pregnancy-associated plasma protein A measured in the first trimester as parameters of subsequent pre-eclampsia and small-for-gestational-age infants: A prospective observational study

et al. 2017

View full text Add to dashboard Cite

ObjectiveTo examine the first-trimester maternal serum placental growth factor (PlGF) and pregnancy-associated plasma protein A (PAPP-A) levels in pregnancies associated with pre-eclampsia (PE) or small-for-gestational-age (SGA) infants, and determine the predictive accuracy of PlGF and of PAPP-A for either PE or SGA infants.MethodsThis prospective, observational study included 175 pregnant women, and of these women, due to participant withdrawal or loss to follow-up, delivery data were collected from the medical records of 155 women, including 4 who had twin pregnancies. The women's maternal history was recorded, and the PlGF and PAPP-A levels at 11 to 13 gestational weeks were measured. During the second trimester, the maternal uterine artery's systolic/diastolic ratio was measured. Multiples of the median (MoM) of PlGF and PAPP-A were determined, and the associations of these values with the risk factors of SGA and PE were evaluated. Logistic regression analysis was used to determine whether PlGF and PAPP-A are useful markers for predicting SGA infants.ResultsThe PAPP-A MoM level was significantly lower in women with advanced maternal age, multipara women, and women with gestational diabetes than in their counterparts. The PlGF and PAPP-A MoM levels were higher in women with a twin pregnancy than in those with a singleton pregnancy. There was a significant relationship between the maternal serum PAPP-A MoM level in the first trimester and the uterine artery systolic/diastolic ratio in the second trimester. Results of logistic regression analysis showed that low PlGF and PAPP-A MoM levels were predictors of SGA infants (odds ratio, 0.143; 95% confidence interval, 0.025 to 0.806; odds ratio, 0.191; 95% confidence interval, 0.051 to 0.718, respectively).ConclusionPlGF and PAPP-A are potentially useful as first-trimester markers for SGA infants and some hypertensive disorders of pregnancy.

show abstract

Section: Discussionsupporting

confidence: 92%

Maternal serum placental growth factor and pregnancy-associated plasma protein A measured in the first trimester as parameters of subsequent pre-eclampsia and small-for-gestational-age infants: A prospective observational study

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Although the placenta is central to the process, it remains unclear; however, what causes sFlt-1 to increase and PlGF to decrease in women with preeclampsia or multiple gestation. 26 This study and others 27,28 demonstrate that women with twins can have much higher sFlt-1/PlGF levels (compared to singletons) and not develop preeclampsia. It is unclear why but it probably points to the multifactorial aspect of this disease.…”

Section: Commentsupporting

confidence: 54%

“…19,23 While we showed findings for maternal s-endoglin similar to those for sFlt-1 at the end of pregnancy, another study found no differences in the first trimester. 20 The etiology of the increases in sFlt1 has been hypothesized to be related to increased placental mass in twins as the placenta is thought to be the major source of sFlt. 24 Although the placenta is also the major source of PlGF, dramatic changes in PlGF are not seen with increased placental mass as the commercial assays to measure PlGF only measure the unbound form or free PlGF.…”

Section: Commentmentioning

confidence: 99%

“…18–20 The timing of these changes in angiogenic balance may provide insight into the mechanism whereby preeclampsia risk is elevated in women carrying multiple gestations. Therefore, we followed women longitudinally through pregnancy and delivery to examine circulating maternal concentrations of placental growth factor (PlGF), sFlt-1, and s-endoglin in twin and singleton pregnancies.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Maternal circulating angiogenic factors in twin and singleton pregnancies

Faupel-Badger

McElrath

Lauria

et al. 2015

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

Objective The purpose of this study was to compare longitudinally sampled maternal angiogenic proteins between singleton and twin pregnancies. Study Design Placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), and soluble endoglin (sEng) from healthy pregnant women were quantified at 10, 18, 26 and 35 weeks’ gestation (n=91), and during the third trimester (31–39 weeks) and at delivery (33–41 weeks; n=41). Geometric means and 95% confidence intervals were calculated for gestational age adjusted angiogenic protein concentrations and compared between matched twin and singleton pregnancies. Results Maternal sFlt-1 concentrations and the sFlt-1/PlGF ratio were higher in twins than singletons across pregnancy and at delivery, with the greatest differences at week 35 [sFlt-1: 36916 vs. 10151 pg/mL; p<0.0001; sFlt-1/PlGF: 168.4 vs. 29.0; p<0.0001]. Maternal concentrations of s-endoglin also were higher in the third trimester and delivery. Maternal PlGF concentrations were lower in twin than singleton pregnancies at week 35 only [219.2 vs. 350.2 pg/mL; p<0.0001]. Placental weight appeared to be inversely correlated with maternal sFlt-1/PlGF ratio at the end of the pregnancy in both twins and singletons. Conclusions Higher maternal anti-angiogenic proteins in twin than singleton pregnancies does not appear to be due to greater placental mass in the former, and may be one explanation for the increased risk of preeclampsia in women carrying multiple gestations. Determining whether women with a history of multiple gestations have an altered cardiovascular disease and breast cancer risk, like those with a history of preeclampsia, is warranted.

show abstract

“…Another group has reported PlGF levels to be 59% higher in 61 dichorionic twins compared to 50 singletons when measured around 12 weeks on a different assay, and although they measure PlGF levels in 12 monochorionic pregnancies, they excluded these from analysis. Different commercial assays may detect the isoforms of PlGF differently, dependent upon the antibody pairs used.…”

Section: Discussionmentioning

confidence: 99%

First trimester maternal serum placental growth factor levels in twin pregnancies

Cowans

Spencer

2013

Prenatal Diagnosis

View full text Add to dashboard Cite

show abstract

First trimester serum angiogenic/anti-angiogenic status in twin pregnancies: relationship with assisted reproduction technology

Abstract: In the first trimester, twin pregnancies conceived using ART showed a heightened anti-angiogenic status that could explain the increased risk of PE in these cases.

Cited by 25 publications

References 45 publications

Maternal serum placental growth factor and pregnancy-associated plasma protein A measured in the first trimester as parameters of subsequent pre-eclampsia and small-for-gestational-age infants: A prospective observational study

Maternal serum placental growth factor and pregnancy-associated plasma protein A measured in the first trimester as parameters of subsequent pre-eclampsia and small-for-gestational-age infants: A prospective observational study

Maternal circulating angiogenic factors in twin and singleton pregnancies

First trimester maternal serum placental growth factor levels in twin pregnancies

Contact Info

Product

Resources

About