Artículo de interés - Angiogenic imbalance in maternal and cord blood is associated with neonatal birthweight and head circumference biometrics in major fetal congenital heart defects
Sánchez O, Ribera I, Ruiz A, Eixarch E, Antolín E, Cruz-Lemini M, Dominguez C, Arévalo S, Ferrer Q, Rodríguez-Sureda V, Crispi F, Llurba E.
Ultrasound Obstet Gynecol. 2023 Jul 31
Nuevo artículo de interés para la RICORS-SAMID
Articulo colaborativo: RD21/0012/0001, RD21/0012/0014 y CA10
Objective: To ascertain whether abnormalities in fetal head circumference and/or estimated body weight are associated with angiogenic factors in maternal and cord blood and if the specific type of congenital heart defect (CHD) influences this association.
Methods: Multicentric case-control study for major CHD. Recruitment was carried out between June 2010 and July 2018 at four tertiary care hospitals in Spain. Maternal venous blood was drawn at study inclusion and at delivery. Cord blood samples from fetuses with CHD were obtained at birth when possible. Placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), and soluble endoglin (sEng) were measured in maternal and cord blood.
Results: PlGF, sFlt-1, and sEng levels were measured in maternal and cord blood in 237 cases with CHD and 260 healthy controls. Compared to controls, median PlGF values in maternal blood were significantly lower in the CHD group (MoM: 0.959 vs. 1.022; P <0.0001) and the median sFlt-1/PlGF was significantly higher (MoM: 1.032 vs. 0.974; P=0.0085); no between-group differences were observed in sEng values (MoM: 0.981 vs. 1.011; P=0.4673). Levels of sFlt-1 and sEng were significantly higher in cord blood obtained from fetuses with CHD versus controls (447 ± 51 vs. 264 ± 20 pg/mL; P=0.0470 and 8.30 ± 0.92 vs. 5.69 ± 0.34 ng/mL, P=0.0430, respectively). Maternal concentrations of sFlt-1 and the sFlt-1/PlGF ratio at study inclusion were negatively associated with birth weight and head circumference in CHD group.
Conclusion: These data demonstrate the presence of an anti-angiogenic profile in maternal and cord blood in women carrying a fetus with CHD. This study shows, for the first time, that this imbalance is adversely associated with fetal head circumference and birth weight.