Lorenz-Meyer Lisa Antonia, Frank Lisa, Sroka Dorota, Busjahn Andreas, Henrich Wolfgang, Verlohren Stefan
Department of Obstetrics, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany.
Klinik für Gynäkologie und Geburtshilfe, Helios Klinikum Berlin-Buch, Berlin, Germany.
Pregnancy Hypertens. 2022 Jun;28:149-155. doi: 10.1016/j.preghy.2022.04.002. Epub 2022 Apr 13.
The angiogenic factors sFlt-1 (soluble fms-like tyrosine kinase) and PlGF (Placental Growth Factor) play a key role in the pathophysiology, prediction and diagnosis of preeclampsia-associated pregnancy disorders. However, the correlation between maternal serum levels and the placental weight, especially in hypertensive pregnancy disorders is still unclear.
Retrospectively, we analyzed data from a real-world cohort of patients with preeclampsia (PE), intrauterine growth restriction (IUGR), PE + IUGR and controls giving birth within 14 days from inclusion. Herein, correlational analyses were calculated between placental weight, maternal serum levels of sFlt-1, PlGF and the respective sFlt-1/PlGF-ratios.
This study included n = 328 patients (n = 134 with PE, n = 40 with IUGR and n = 25 showed PE + IUGR) and n = 129 controls. The gestational age-adjusted placental weight was significantly decreased in patients with PE ± IUGR, but not in PE alone, when comparing to controls. Correlation between PlGF and the placental weight was significantly positive and increasing with severity of disease (controls 0.134, p = 0.131, PE 0.419, p < 0.01, IUGR 0.517, p < 0.01, PE + IUGR r = 0.723, p < 0.01). Furthermore, an inverse correlation between the sFlt-1/PlGF-ratio and the placental weight was found. The sFlt-1/PlGF-ratio per gram placental weight was highest in patients with PE + IUGR and lowest in controls (0.6 (IQR 0.4-1.8) vs. 0.05 (IQR 0.02-0.15)).
A correlation between the serum levels of sFlt-1 and PlGF and the placental weight is present in PE-associated pregnancy disorders. This mirrors the model of an angiogenic continuum in the placenta where the serum sFlt-1 to PlGF ratio increases with severity of the disease.
血管生成因子sFlt-1（可溶性fms样酪氨酸激酶）和PlGF（胎盘生长因子）在子痫前期相关妊娠疾病的病理生理学、预测和诊断中起关键作用。然而，母体血清水平与胎盘重量之间的相关性，尤其是在高血压妊娠疾病中仍不清楚。
我们回顾性分析了一组来自真实世界队列的数据，该队列包括子痫前期（PE）、胎儿生长受限（IUGR）、PE + IUGR患者以及纳入研究后14天内分娩的对照组。在此，计算了胎盘重量、母体血清sFlt-1、PlGF水平以及各自的sFlt-1/PlGF比值之间的相关性分析。
本研究纳入了n = 328例患者（n = 134例PE患者，n = 40例IUGR患者，n = 25例显示为PE + IUGR）和n = 129例对照组。与对照组相比，PE ± IUGR患者经孕周校正后的胎盘重量显著降低，但单独PE患者无此现象。PlGF与胎盘重量之间的相关性显著为正，且随疾病严重程度增加（对照组0.134，p = 0.131，PE 0.419，p < 0.01，IUGR 0.517，p < 0.01，PE + IUGR r = 0.723，p < 0.01）。此外，发现sFlt-1/PlGF比值与胎盘重量呈负相关。每克胎盘重量的sFlt-1/PlGF比值在PE + IUGR患者中最高，在对照组中最低（0.6（四分位间距0.4 - 1.8）对0.05（四分位间距0.02 - 0.15））。
在子痫前期相关妊娠疾病中，sFlt-1和PlGF的血清水平与胎盘重量之间存在相关性。这反映了胎盘中血管生成连续统一体的模型，即血清sFlt-1与PlGF的比值随疾病严重程度增加而升高。
