The role of an ‘anti-angiogenic state’ in complications of pregnancy

Renzo, Di

doi:10.1080/14767050701855081

Cited by 10 publications

(6 citation statements)

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“…This state appears to result from an imbalance in the production and circulating concentrations of angiogenic factors such as placental growth factor (PlGF) and vascular endothelial growth factor (VEGF) and anti-angiogenic factors such as soluble VEGF receptor-1 (sVEGFR-1) and soluble endoglin (sEng). Elevated serum and plasma concentrations of sVEGFR-1 and s-Eng have been observed after the diagnosis of PE [1][2][3][7][8][9]11,12,15,18,19,[21][22][23] and before the recognition of clinical disease [4][5][6]10,13,14,16,17,20,30,32].…”

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confidence: 99%

The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age

Erez

Romero

Espinoza

et al. 2008

The Journal of Maternal-Fetal & Neonatal Medicine

273

233

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The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age, The Journal of Maternal-Fetal & Neonatal Medicine, 21:5, 279-287, DOI: 10.1080 AbstractIntroduction. An imbalance between angiogenic and anti-angiogenic factors has been proposed as central to the pathophysiology of preeclampsia (PE). Indeed, patients with PE and those delivering small-for-gestational age (SGA) neonates have higher plasma concentrations of soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and the soluble form of endoglin (s-Eng), as well as lower plasma concentrations of vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) than do patients with normal pregnancies. Of note, this imbalance has been observed before the clinical presentation of PE or the delivery of an SGA neonate. The objective of this study was to determine if changes in the profile of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters are associated with a high risk for the subsequent development of PE and/or delivery of an SGA neonate. Methods. This longitudinal case-control study included 402 singleton pregnancies in the following groups: (1) normal pregnancies with appropriate for gestational age (AGA) neonates (n ¼ 201); (2) patients who delivered an SGA neonate (n ¼ 145); and (3) patients who developed PE (n ¼ 56). Maternal plasma samples were obtained at the time of each prenatal visit, scheduled at 4-week intervals from the first or early second trimester until delivery. In this study, we included two samples per patient: (1) first sample obtained between 6 and 15 weeks of gestation ('first trimester' sample), and (2) second sample obtained between 20 and 25 weeks of gestation ('second trimester' sample). Plasma concentrations of s-Eng, sVEGFR-1, and PlGF were determined by specific and sensitive immunoassays. Changes in the maternal plasma concentrations of these angiogenesis-related factors were compared among normal patients and those destined to develop PE or deliver an SGA neonate while adjusting for maternal age, nulliparity, and body mass index. General linear models and polytomous logistic regression models were used to relate the analyte concentrations, ratios, and product to the subsequent development of PE and SGA. Results.(1) An increase in the maternal plasma concentration of s-Eng between the first and second trimesters conferred risk for the development of preterm PE and SGA (OR 14.9, 95% CI 4.9-45.0 and OR 2.9, 95% CI 1.5-5.6, respectively).(2) An increase in the maternal plasma concentration of sVEGFR-1 between the first and second trimester conferred risk for the development of preterm PE (OR 3.9, 95% CI 1.2-12.6). (3) A subnormal increase in maternal plasma PlGF concentration between the first and the second trimester was a risk factor for the subsequent development of preterm and term PE (OR 4....

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confidence: 99%

The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age

Erez

Romero

Espinoza

et al. 2008

The Journal of Maternal-Fetal & Neonatal Medicine

273

233

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“…A successful pregnancy requires the development of an adequate utero‐placental circulation and impaired placental villous vascularization is demonstrated in the pathophysiology of small for gestational age pregnancies [3,25]. The angiogenic potential of cord blood endothelial colony forming cells (ECFC) is impaired and the expression of both TSP‐1 mRNA and protein is increased in low birth weight preterm infants [4].…”

Section: Discussionmentioning

confidence: 99%

“…Small for gestational age (SGA) infants are at increased risk of later life vascular disorders, including hypertension, coronary artery disease and stroke [1,2]. It is increasingly being recognized that an anti‐angiogenic state is implicated in the pathophysiology of SGA pregnancies [3]. It is proposed that an angiogenic defect originating during the antenatal period may contribute to the risk of SGA and later‐life vascular disorders.…”

Section: Introductionmentioning

confidence: 99%

A functional variant in the thrombospondin‐1 gene and the risk of small for gestational age infants

Andraweera

Dekker

Thompson

et al. 2011

Journal of Thrombosis and Haemostasis

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Summary. Introduction: Thrombospondin‐1 (TSP‐1) is a prothrombotic and anti‐angiogenic glycoprotein expressed in the placenta. A functional single nucleotide polymorphism in the TSP‐1 gene (TSP‐1 A2210G) is a risk factor for familial premature myocardial infarction. Small for gestational age (SGA) infants are at increased risk of coronary artery disease in adult life and common genetic factors may underlie both conditions. We investigated the association of TSP‐1 A2210G in SGA infants and their parents. Method: The 3234 nulliparous pregnant women, their partners and babies were recruited in Adelaide and Auckland to a prospective multicenter cohort study. Amongst 2123 Caucasian women, 216 (10.2%) delivered an SGA infant, defined as birth weight < 10th customized centile adjusted for maternal height, weight, parity and ethnicity, as well as gestational age at delivery and infant sex. Uncomplicated pregnancies served as controls (n = 1185). DNA extracted from peripheral/cord blood or buccal swabs was genotyped using Sequenom MassARRAY. Multivariable logistic regression was used to compare the odds of SGA between the genotype groups adjusting for potential confounders. Results: Paternal (adjOR, 1.4; 95% CI 1.0–2.0) and neonatal (adjOR, 1.8; 95% CI, 1.1–2.7) TSP‐1 A2210G associates with SGA. The maternal polymorphism approaches significance for an association with SGA (adjOR, 1.3; 95% CI, 0.9–1.9). Maternal TSP‐1 A2210G associates with a reduced maternal birth weight adjusted for gestational age at delivery (P = 0.03). Conclusion: The TSP‐1 A2210G polymorphism, which is a risk factor for myocardial infarction, is associated with SGA pregnancies, suggesting that this polymorphism may associate with the risk of vascular disorders across the life course.

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“…У стінці матки цитотрофобласт проникає у спіральні артерії і досягає їхньої ендотеліальної вистилки, при цьому відбувається лізис гладком'язової стінки, за рахунок чого спіральні артерії набувають властивостей, необхідних для адекватної перфузії плаценти. При ВАС відбувається порушення глибини проникнення клітин цитотрофобласта, гестаційна трансформація спіральних артерій здійснюється не повною мірою, що пов'язано з порушенням їхнього ремоделювання і обструктивними ураженнями [16][17][18].…”

Section: особенности акушерской и перинатальной патологии у беременны...unclassified

Obstetric and perinatal pathology in pregnant women who had complications from the group of the Great Obstetrical Syndromes

Lemish

2022

RHW

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The objective: to analyze the obstetric and perinatal outcomes of childbirth in pregnant women who had complications from the group of the great obstetrical syndromes.Materials and methods. A retrospective statistical analysis of obstetric and perinatal outcomes of childbirth of 239 pregnant women (the Ist group – main one) who had complications from the group of the great obstetrical syndromes (GOS). They were divided into three subgroups: Ia subgroup included 103 pregnant women with severe preeclampsia (PE), Ib subgroup – 67 pregnant women with placental insufficiency, with clinical manifestation of fetal intrauterine growth retardation (IUGR), Ic subgroup – 69 pregnant women with spontaneous preterm birth in the gestational age 22-36 weeks. The control group (CG) included 56 practically healthy pregnant women with a normal reproductive history and uncomplicated course of this pregnancy.Statistical processing of the study results was performed using standard programs Microsoft Excel 5.0 and Statistica 6.0.Results. The incidence of gestational diabetes mellitus in patients of the I group (28 (11.7 %) women) was higher than in CG (2 (3.6 %) persons). Cervical insufficiency was diagnosed in every fifth patient of Ic subgroup (12 (17.3 %) patients; χ2=15.56, p<0.01; OR=9.25; CI 95%: 2.55–33.54 relative to CG), gestational anemia – in 179 (74.8 %) pregnant women in the I group and 18 (32.1 %) women in CG (p<0.01).A significantly high rate of mild congenital malformations was present in subgroup Ib (7 (10.4 %) of pregnant women; χ2=12.67, p<0.01; OR=7.93; CI 95%: 2.14-29.26). 21 patients in the I group had with antenatal fetal death, 6 (5.8 %) – severe PE, 11 (16.4 %) – IUGR. Five cases of early neonatal mortality was diagnosed in the I group. The rate of perinatal mortality in the I group was high and amounted to 108.7 ‰.The operative delivery in the I group was performed in 127 (53.1 %) patients which is significantly more than in CG (χ2=42.93, p<0.01; OR=4.93; CI 95%: 2.99– 8.13). In 24 (18.9 %) pregnant women in the I group the indication for operative delivery was acute distress, which is significantly more than in CG (2 (3.6 %) women; χ2=7.36, p<0.01; OR=5.17; CI 95%: 1.2–22.28). The mean score on the Apgar scale in newborns in CG was significantly higher compared with the I group (p<0.01).Conclusions. The course of pregnancy and childbirth in women who had complications from the group of the great obstetrical syndromes was accompanied by the development of gestational diabetes, gestational anemia and cervical insufficiency. Complications such as fetal distress, severe preeclampsia, fetal growth retardation with decompensated hemodynamic disorders of the uterine and placental blood circulation, led to a high frequency of cesarean section in these patients.

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The role of an ‘anti-angiogenic state’ in complications of pregnancy

Cited by 10 publications

References 89 publications

The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age

The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age

A functional variant in the thrombospondin‐1 gene and the risk of small for gestational age infants

Obstetric and perinatal pathology in pregnant women who had complications from the group of the Great Obstetrical Syndromes

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