Murtoniemi K, Vahlberg T, Hämäläinen E, Kajantie E, Pesonen A K, Räikkönen K, Taipale P, Villa P M, Laivuori H
Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, P.O. Box 63, FI-00014 University of Helsinki, Finland; Department of Obstetrics and Gynaecology, University of Turku and Turku University Hospital, PO Box 52, FI-20521 Turku, Finland.
Department of Clinical Medicine, Biostatistics, University of Turku and Turku University Hospital, FI-20014 University of Turku, Finland.
Pregnancy Hypertens. 2018 Jul;13:51-57. doi: 10.1016/j.preghy.2018.04.003. Epub 2018 Apr 7.
Our first aim was to study the longitudinal changes of serum placental growth factor (PlGF) concentration between 12 and 28 weeks of gestation in the prospective PREDO cohort. Our second aim was to study the effect of low-dose acetylsalicylic acid (LDA; 100 mg/day), started before the 14th week of gestation, on PlGF concentration.
Blood samples were collected at 12-14, 18-20 and 26-28 weeks of gestation in 101 women without and 309 with clinical risk factors for pre-eclampsia. Risk-women were divided into two groups: to those who had medium risk for pre-eclampsia and to those who had high risk for pre-eclampsia. Finally there were seven groups according to risk, treatment (no prevention/placebo/LDA) and outcome measure pre-eclampsia. Longitudinal changes in the PlGF concentration between groups were compared. To investigate the effect of LDA on serum PlGF concentration, placebo (N = 62) and LDA (N = 61) groups were compared. A repeated measures ANOVA was used to analyze differences in PlGF levels between the groups.
The increase in serum PlGF concentration was higher in LDA than in placebo group (time × group effect, p = 0.046). The increase in serum PlGF concentration during pregnancy was lower in high-risk women who had placebo and developed pre-eclampsia and in medium-risk women who developed pre-eclampsia compared to the other women (time × group effect, p < 0.001). There were no differences in PlGF change between low-risk women, medium-risk women who did not develop pre-eclampsia, high-risk women in the placebo group without pre-eclampsia and high-risk women in the LDA group with and without pre-eclampsia (p = 0.15).
Our finding suggests an association between LDA started before 14 weeks of gestation and higher increase in serum PlGF concentration.
我们的首要目标是在PREDO前瞻性队列研究中，研究妊娠12至28周期间血清胎盘生长因子（PlGF）浓度的纵向变化。我们的第二个目标是研究在妊娠第14周之前开始使用的低剂量乙酰水杨酸（LDA；100毫克/天）对PlGF浓度的影响。
在101名无先兆子痫临床危险因素的女性和309名有先兆子痫临床危险因素的女性中，于妊娠12 - 14周、18 - 20周和26 - 28周采集血样。有风险的女性被分为两组：先兆子痫中度风险组和先兆子痫高度风险组。最终根据风险、治疗（无预防措施/安慰剂/LDA）和结局指标先兆子痫分为七组。比较各组间PlGF浓度的纵向变化。为研究LDA对血清PlGF浓度的影响，比较了安慰剂组（N = 62）和LDA组（N = 61）。采用重复测量方差分析来分析各组间PlGF水平的差异。
LDA组血清PlGF浓度的升高高于安慰剂组（时间×组间效应，p = 0.046）。与其他女性相比，接受安慰剂并发生先兆子痫的高危女性以及发生先兆子痫的中度风险女性在孕期血清PlGF浓度的升高较低（时间×组间效应，p < 0.001）。低风险女性、未发生先兆子痫的中度风险女性、安慰剂组未发生先兆子痫的高危女性以及LDA组有或无先兆子痫的高危女性之间的PlGF变化无差异（p = 0.15）。
我们的研究结果表明，妊娠14周前开始使用LDA与血清PlGF浓度的更高升高之间存在关联。
