Differentiating Maternal Angiogenesis Factors between Early and Late Onset Preeclampsia: Higher sflt-1 in Early Onset Preeclampsia, Lower PlGF and Higher sflt-1/PlGF Ratio in Late Onset Preeclampsia
Abstract
Background: Early onset preeclampsia (PE) is considered a fetal disorder that is associated with placental dysfunction. While late onset preeclampsia is considered a maternal disorder that associated with a normal placenta. An imbalance of angiogenesis factors, namely soluble Fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) is not only a strong predictor of PE but can also be a predictor of poor outcomes or adverse complications of PE. This study was conducted to analyze the difference between angiogenesis factor sFlt-1 and PlGF in maternal serum between patients with early and late onset PE.
Material and Methods: This was a cross-sectional study involving pregnant women with PE who were ≥18 years old and gestational age >20 weeks had singleton pregnancies. Subjects who had a major morphological abnormality of a fetus diagnosed with USG and chromosomal abnormality of the fetus were be excluded. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were measured using a digital blood pressure measuring instrument. sFlt-1 and PlGF levels were measured using enzyme linked immunosorbent assay (ELISA).
Result: This study showed the level of maternal serum sFlt-1 was 7522.95 pg/mL and the level of maternal serum PlGF was 222.25 pg/mL. There was a difference between sflt-1, PlGF, and the sflt-1/PlGF ratio (p=0.00; p=0.00; p=0.00) in early and late onset of PE where at early onset PE was found higher sflt-1 and late-onset PE had lower PlGF and higher sflt-1/PlGF ratio.
Conclusion: There are differences in sFlt-1, PlGF, and sFlt-1/PlGF in early and late onset PE, as higher sflt-1 is found in early onset preeclampsia, while lower PlGF and higher sflt-1/PlGF ratio are found in late onset preeclampsia.
Keywords: early onset, late onset, preeclampsia, maternal angiogenesis factor, Flt-1, PlGF
Full Text:
PDFReferences
Saleh L, Vergouwe Y, van den Meiracker AH, Verdonk K, Russcher H, Bremer HA, et al. Angiogenic markers predict pregnancy complications and prolongation in preeclampsia. Hypertension. 2017; 70(5): 1025-33, CrossRef.
Liu N, Guo YN, Gong LK, Wang BS. Advances in biomarker development and potential application for preeclampsia based on pathogenesis. Eur J Obstet Gynecol Reprod Biol X. 2021; 9:100119, CrossRef.
Reddy M, Springhall EA, Rolnik DL, da Silva Costa F. How to perform first trimester combined screening for pre-eclampsia. Australas J Ultrasound Med. 2018; 21(4): 191-7, CrossRef.
Phipps E, Prasanna D, Brima W, Jim B. Preeclampsia: Updates in pathogenesis, definitions, and guidelines. Clin J Am Soc Nephrol. 2016; 11(6): 1102-13, CrossRef.
Burton GJ, Redman CW, Roberts JM, Moffett A. Pre-eclampsia: pathophysiology and clinical implications. BMJ. 2019; 366: l2381, CrossRef.
Pant V, Yadav BK, Sharma J. A cross sectional study to assess the sFlt-1:PlGF ratio in pregnant women with and without preeclampsia. BMC Pregnancy Childbirth. 2019; 19(1): 266, CrossRef.
Lokeswara AW, Hiksas R, Irwinda R, Wibowo N. Preeclampsia: From cellular wellness to inappropriate cell death, and the roles of nutrition. Front Cell Dev Biol. 2021; 9: 726513, CrossRef.
Joško O, Kristina K. Clinical, biochemical, and biophysical markers of angiogenesis in preeclampsia. In: Sharma N, editor. Prediction of Maternal and Fetal Syndrome of Preeclampsia. London: IntechOpen; 2019. p.59-76, CrossRef.
Verlohren S, Dröge LA. The diagnostic value of angiogenic and antiangiogenic factors in differential diagnosis of preeclampsia. Am J Obstet Gynecol. 2022; 226(2): S1048-58, CrossRef.
Rana S, Powe CE, Salahuddin S, Verlohren S, Perschel FH, Levine RJ, et al. Angiogenic factors and the risk of adverse outcomes in women with suspected preeclampsia. Circ. 2012; 125(7): 911-9, CrossRef.
Karpova NS, Dmitrenko OP, Budykina TS. Literature review: The sFlt1/PlGF ratio and pregestational maternal comorbidities: New risk factors to predict pre-eclampsia. Int J Mol Sci. 2023; 24(7): 6744, CrossRef.
Chen C, Lei Z, Xiong Y et al. Gestational weight gain of multiparas and risk of primary preeclampsia: A retrospective cohort study in Shanghai. Clin Hypertens. 2023; 29(32), CrossRef.
You SH, Cheng PJ, Chung TT, Kuo CF, Wu HM, Chu PH. Population-based trends and risk factors of early- and late-onset preeclampsia in Taiwan 2001-2014. BMC Pregnancy Childbirth. 2018; 18(1): 199, CrossRef.
Andina R. Differences ratio level soluble fms-like tyrosine kinase-1 and placental growth factor early and late onset on preeclampsia and normal pregnancy. J Midwifery. 2018; 3(1): 83-92, CrossRef.
Chen J, Khalil RA. Matrix metalloproteinases in normal pregnancy and preeclampsia. Prog Mol Biol Transl Sci. 2017; 148: 87-165, CrossRef.
McLaughlin K, Snelgrove JW, Audette MC, Syed A, Hobson SR, Windrim RC, et al. PlGF (Placental growth factor) testing in clinical practice: Evidence from a Canadian tertiary maternity referral center. Hypertension. 2021; 77(6): 2057-65, CrossRef.
Birdir C, Droste L, Fox L, Frank M, Fryze J, Enekwe A, et al. Predictive value of sFlt-1, PlGF, sFlt-1/PlGF ratio and PAPP-A for late-onset preeclampsia and IUGR between 32 and 37 weeks of pregnancy. Pregnancy Hypertens. 2018; 12: 124-8, CrossRef.
Yoshimoto R, Fukuta T, Ueno T, Yamada T, Takeda T, Tano S, et al. The usefulness of sFlt-1/PlGF on late onset preeclampsia. Pregnancy Hypertens. 2018; 13: S95-6, CrossRef.
Redman CW. Early and late onset preeclampsia: Two sides of the same coin. Pregnancy Hypertens. 2017; 7: 58, CrossRef.
Robillard PY, Dekker G, Scioscia M, Saito S. Progress in the understanding of the pathophysiology of immunologic maladaptation related to early-onset preeclampsia and metabolic syndrome related to late-onset preeclampsia. Am J Obstet Gynecol. 2022; 226(2): S867-75, CrossRef.
Muhammad I, Indah M, Plasma level of umbilical cord hemeoxygenase-1 (HO-1) and neonatal outcome in early onset and late onset severe preeclampsia. Mol Cell Biomed Sci. 2019; 3(1): 54-9, CrossRef.
Rahmi L, Herman RB. Perbedaan rerata kadar soluble Fms-like tyrosine kinase-1 (Sflt-1) serum pada penderita early onset, late onset preeklampsia berat/eklampsia dan kehamilan normal. J Kesehat Andalas. 2016; 5(1), CrossRef.
Nafratilova L, Wahid I. Differences in level Fms-like tyrosine kinase-1 (sFlt-1), soluble endoglin (s-Eng), and placental growth factor (PIGF) between early onset preeclampsia and late onset preeclampsia. J Midwifery. 2018; 3(2):11-8, CrossRef.
Stepan H, Herraiz I, Schlembach D, Verlohren S, Brennecke S, Chantraine F, et al. Implementation of the sFlt-1/PlGF ratio for prediction and diagnosis of pre-eclampsia in singleton pregnancy: Implications for clinical practice. Ultrasound Obstet Gynecol. 2015; 45(3): 241-6, CrossRef.
Villa PM, Hämäläinen E, Mäki A, Räikkönen K, Pesonen AK, Taipale P, et al. Vasoactive agents for the prediction of early-and late-onset preeclampsia in a high-risk cohort. BMC Pregnancy Childbirth 2013; 13: 110, CrossRef.
DOI: https://doi.org/10.21705/mcbs.v8i3.465
Copyright (c) 2024 Cell and BioPharmaceutical Institute
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Indexed by:
Cell and BioPharmaceutical Institute