The relationship of angiogenic factors to maternal and neonatal manifestations of early-onset and late-onset preeclampsia.

OBJECTIVE: An imbalance between angiogenic and antiangiogenic factors has been implicated in the pathogenesis and severity of preeclampsia. In this study, we evaluated serum levels of an angiogenic factor and an antiangiogenic factor - placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt-1), respectively - in pregnant women with preeclampsia, as well as evaluating the impact of those factors on maternal and fetal outcomes.

METHOD: We studied 44 pregnant women diagnosed with preeclampsia and admitted to an intensive care unit (ICU). The preeclampsia was classified (by weeks of gestation at delivery) as early-onset (<34 weeks) or late-onset (≥34 weeks). We analyzed serum PlGF and sFlt-1, as well as urinary PlGF at admission to the ICU.

RESULTS: In the early-onset preeclampsia group, the sFlt-1/PlGF ratio was higher, as was serum sFlt-1, whereas serum PlGF was lower. Serum sFlt-1 and the sFlt-1/PlGF ratio correlated positively with proteinuria and length of maternal hospital stay and correlated negatively with birth weight. The sFlt-1/PlGF ratio correlated positively with length of newborn stay in the neonatal ICU.

CONCLUSION: Angiogenic imbalance is more pronounced in patients with early-onset preeclampsia and correlates with worse clinical outcomes, especially for the neonates.