Circulating angiogenic factors in singleton vs multiple-gestation pregnancies

Sharon E. Maynard, George Washington University Medical Center
Tiffany A. Moore Simas, University of Massachusetts Medical School
Matthew J. Solitro, University of Massachusetts Medical School
Abraham Rajan, University of Massachusetts Medical School
Sybil L. Crawford, University of Massachusetts Medical School
Peter Soderland, University of Massachusetts Medical School
Bruce A. Meyer, University of Massachusetts Medical School

Abstract

OBJECTIVE: Placental soluble fms-like tyrosine kinase-1 may contribute to the pathogenesis of preeclampsia. Here we describe alterations in serum angiogenic factor levels in women with multiple gestation pregnancies, a major preeclampsia risk factor.

STUDY DESIGN: We collected serial serum specimens from 101 pregnant women at high preeclampsia risk between 22 and 36 weeks' gestation. Soluble fms-like tyrosine kinase-1 and placental growth factor were measured by enzyme-linked immunosorbent assay. Women who had preeclampsia or gestational hypertension develop were excluded.

RESULTS: Maternal soluble fms-like tyrosine kinase-1 was higher in multiple gestation (n = 20) compared with high-risk singleton (n = 81) pregnancies for each gestational age range examined. Maternal placental growth factor was significantly higher in multiple vs high-risk singletons before 31 weeks' gestation, whereas the soluble fms-like tyrosine kinase-1/placental growth factor ratio was higher in multiple vs high-risk singletons after 27 weeks.

CONCLUSION: Alterations in circulating angiogenic factors are present in women with multiple gestations and may contribute to higher preeclampsia risk in this population.