Detection of angiogenic factors in midtrimester amniotic fluid and the prediction of preterm birth

Taiwan J Obstet Gynecol. 2016 Aug;55(4):539-44. doi: 10.1016/j.tjog.2015.04.007.

Abstract

Objective: We investigated whether the level of vascular endothelial growth factor (VEGF), placental growth factor (PlGF), and soluble VEGF receptor-1 (sFlt-1) in midtrimester amniotic fluid of preterm birth have different values compared with term delivery.

Materials and methods: Our participants were 86 pregnant women who had undergone amniocentesis from 16 to 19 weeks of gestation. Forty-three cases were women with preterm delivery, and the other 43 cases were matched women with full-term delivery. Stored amniotic fluid was investigated after the delivery. The levels of VEGF, PlGF, and sFlt-1 were measured by enzyme-linked immunosorbent assay and Western blot.

Results: The levels of VEGF and PlGF in the preterm group were significantly higher than in the control group (30.48 ± 8.57 pg/mL vs. 26.06 ± 8.24 pg/mL and 28.83 ± 7.83 pg/mL vs. 25.35 ± 8.26 pg/mL, respectively) (p = 0.017 and 0.048, respectively). In terms of sFlt-1, the levels were decreased in the preterm group (10,478.51 ± 4012.56 pg/mL vs. 12,544.05 ± 4140.96 pg/mL) (p = 0.021).

Conclusion: This study explains that elevated levels of VEGF and PlGF, suggestive of angiogenesis and tendency of inflammation at midtrimester, are predictive of preterm delivery, and their availability is maximized by downregulation of sFlt-1.

Keywords: amniotic fluid; placenta growth factor; premature birth; vascular endothelial growth factor; vascular endothelial growth factor receptor.

MeSH terms

  • Adult
  • Amniocentesis
  • Amniotic Fluid / chemistry*
  • Angiogenesis Inducing Agents / analysis*
  • Biomarkers / analysis
  • Case-Control Studies
  • Female
  • Gestational Age
  • Humans
  • Placenta Growth Factor / analysis
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Trimester, Second*
  • Premature Birth / etiology*
  • Prospective Studies
  • Risk Factors
  • Vascular Endothelial Growth Factor Receptor-1 / analysis
  • Vascular Endothelial Growth Factors / analysis

Substances

  • Angiogenesis Inducing Agents
  • Biomarkers
  • Vascular Endothelial Growth Factors
  • Placenta Growth Factor
  • FLT1 protein, human
  • Vascular Endothelial Growth Factor Receptor-1