Document Detail


Unexplained fetal death is associated with increased concentrations of anti-angiogenic factors in amniotic fluid.
MedLine Citation:
PMID:  20199197     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Angiogenesis is critical for successful pregnancy. An anti-angiogenic state has been implicated in preeclampsia, fetal growth restriction and fetal death. Increased maternal plasma concentrations of the anti-angiogenic factor, soluble vascular endothelial growth factor receptor (sVEGFR)-1, have been reported in women with preeclampsia and in those with fetal death. Recent observations indicate that an excess of sVEGFR-1 and soluble endoglin (sEng) is also present in the amniotic fluid of patients with preeclampsia. The aim of this study was to determine whether fetal death is associated with changes in amniotic fluid concentrations of sVEGFR-1 and sEng, two powerful anti-angiogenic factors. Study design. This cross-sectional study included patients with fetal death (n = 35) and controls (n = 129). Fetal death was subdivided according to clinical circumstances into: (1) unexplained (n = 25); (2) preeclampsia and/or placental abruption (n = 5); and (3) chromosomal/congenital anomalies (n = 5). The control group consisted of patients with preterm labor (PTL) who delivered at term (n = 92) and women at term not in labor (n = 37). AF concentrations of sVEGFR-1 and sEng were determined by ELISA. Non-parametric statistics and logistic regression analysis were applied. Results. (1) Patients with a fetal death had higher median amniotic fluid concentrations of sVEGFR-1 and sEng than women in the control group (p < 0.001 for each); (2) these results remained significant among different subgroups of stillbirth (p < 0.05 for each); and (3) amniotic fluid concentrations of sVEGFR-1 and those of sEng above the third quartile were associated with a significant risk of unexplained preterm fetal death (adjusted OR = 10.8; 95%CI 1.3-89.2 and adjusted OR 87; 95% CI 2.3-3323, respectively). Conclusion. Patients with an unexplained fetal death at diagnosis are characterized by an increase in the amniotic fluid concentrations of sVEGFR-1 and sEng. These observations indicate that an excess of anti-angiogenic factors in the amniotic cavity is associated with unexplained fetal death especially in preterm gestations.
Authors:
Tinnakorn Chaiworapongsa; Roberto Romero; Juan P Kusanovic; Zeynep A Savasan; Sun Kwon Kim; Shali Mazaki-Tovi; Edi Vaisbuch; Giovanna Ogge; Ichchha Madan; Zhong Dong; Lami Yeo; Pooja Mittal; Sonia S Hassan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  23     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-16     Completed Date:  2010-11-04     Revised Date:  2011-08-03    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  794-805     Citation Subset:  IM    
Affiliation:
Perinatology Research Branch, NICHD, NIH, DHHS, Detroit, MI 48201, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Amniotic Fluid / metabolism*
Antigens, CD / metabolism*
Cross-Sectional Studies
Female
Fetal Death / metabolism*
Humans
Middle Aged
Pregnancy
Receptors, Cell Surface / metabolism*
Vascular Endothelial Growth Factor Receptor-1 / metabolism*
Young Adult
Chemical
Reg. No./Substance:
0/Antigens, CD; 0/ENG protein, human; 0/Receptors, Cell Surface; EC 2.7.10.1/Vascular Endothelial Growth Factor Receptor-1
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