The role of angiogenic factors in preeclampsia

Preeclampsia is one of the leading causes of maternal and perinatal mortality, and its timely diagnosis is complicated by the multifactorial nature of the disease. The study of angiogenic factors is of key importance for early diagnosis, monitoring, and prevention of complications. Aim - to analyze the content of angiogenesis factors (PlGF and sVEGF) in the blood serum of pregnant women and determine their impact on preeclampsia. Materials and methods. 110 pregnant women were examined: 60 women with preeclampsia (main group) and 50 women with physiological pregnancy (control group). 86.7% of women with preeclampsia had hemodynamic disorders of the fetoplacental complex of varying severity. The content of angiogenic factors (PlGF and sVEGF) in the blood serum was assessed in the I (10-12 weeks of pregnancy), II (18-20 weeks) and III (30-34 weeks) trimester of pregnancy. Statistical analysis was performed using Student's t-test, Mann-Whitney U-test and ANOVA analysis. Results. A decrease in PlGF in the main group was observed from the І trimester (7.89±2.2 pg/ml) and remained below the normative values in the ІІ (83.4±14.3 pg/ml) and ІІІ (62.6±9.1 pg/ml) trimesters. sVEGF in the main group was higher than in the control group in the І (1684±188.1 pg/ml vs. 1232.26±173.9 pg/ml), the ІІ (2289±254.7 pg/ml vs. 1174.35±227.5 pg/ml) and the ІІІ (2675±301.4 pg/ml vs. 1792.19±509 pg/ml) trimesters. The sVEGF/PlGF ratio in the main group was significantly higher than in the control group: 165.6 versus 11.3 in the І trimester; 144.7 versus 18.6 in the ІІ trimester and 112.8 versus 17.3 in the ІІІ trimester. A significant influence of angiogenesis factors on the development of preeclampsia was revealed: PlGF <10 pg/ml - in the І trimester, <80 pg/ml - in the ІІІ trimester; sVEGF ≥1500 pg/ml - in the І trimester, ≥2000 pg/ml - in the ІІ trimester, ≥2500 pg/ml - in the ІІІ trimester of pregnancy. Conclusions. Decreased PlGF and increased sVEGF in the I trimester predict a high probability of preeclampsia and are markers that allow assessing the risk of complications and ensuring timely treatment. The study was conducted in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the local ethics committee of the participating institution. Informed consent was obtained from all patients. No conflict of interests was declared by the authors.