Circulating angiogenic and antiangiogenic factors in women with eclampsia

Abstract

Objective: The objective of the study was to determine whether eclampsia has a different circulating profile of angiogenic (placental growth factor [PlGF]) and antiangiogenic factors (soluble vascular endothelial growth factor receptor-1 [sVEGFR-1] and soluble endoglin [sEng]) from severe preeclampsia.

Study design: This cross-sectional study included pregnant women in the following groups: (1) normal pregnancy (n = 40); (2) severe preeclampsia (n = 40); and (3) eclampsia (n = 20). Maternal serum PlGF, sVEGFR-1, and sEng concentrations were determined using an enzyme-linked immunosorbent assay.

Results: The study results included the following: (1) the median concentration of sVEGFR-1 and sEng was higher and of PlGF was lower in severe preeclampsia or eclampsia than in normal pregnancy (P < .001 for all); and (2) the median concentrations of these 3 analytes did not differ significantly between patients with severe preeclampsia and those with eclampsia.

Conclusion: Eclampsia is associated with higher maternal circulating concentrations of sVEGFR-1 and sEng and lower concentrations of PlGF than normal pregnancy but with similar concentrations to severe preeclampsia. These findings suggest that eclampsia shares a common pathogenic pathway as severe preeclampsia.

Figure 1. Comparison of serum concentration of placental growth factor (PlGF) between women with a normal pregnancy, severe preeclampsia, or eclampsia

The median maternal serum PlGF concentration was lower in patients with severe preeclampsia (190 pg/mL, interquartile range (IQR) 63.1-190.0) or eclampsia (84.3 pg/mL, IQR 44.9-145.9) than that of women with a normal pregnancy (335.6 pg/mL, IQR 220.6-646.0; p<0.001 for both comparisons). The median maternal serum concentration of PlGF was not significantly different between patients with severe preeclampsia and those with eclampsia (p=0.3).

Figure 2. Comparison of serum concentration of soluble vascular endothelial growth factor receptor (sVEGFR)-1 between women with a normal pregnancy, severe preeclampsia, or eclampsia

The median maternal serum sVEGFR-1 concentration was higher in patients with severe preeclampsia (19,070.6 pg/mL, interquartile range (IQR) 12,425.9-35,456.5) or eclampsia (28,527.9 pg/mL, IQR 14,441.1-53,197.3) than that of women with a normal pregnancy (6,483.3 pg/mL, IQR 3,464-8,585.5; p<0.001 for both comparisons). The median maternal serum concentration of sVEGFR-1 was not significantly different between patients with severe preeclampsia and those with eclampsia (p=0.2).

Figure 3. Comparison of serum concentration of soluble endoglin (sEng) between women with a normal pregnancy, severe preeclampsia, or eclampsia

The median maternal serum sEng concentration was higher in patients with severe preeclampsia (37.2 pg/mL, interquartile range (IQR) 21.9-47.8) or eclampsia (46.7 pg/mL, IQR 25.6-107.6) than that of women with a normal pregnancy (12.7 pg/mL, IQR 8.8-19.6; p<0.001 for both comparisons). The median maternal serum concentration of sEng was not significantly different between patients with severe preeclampsia and those with eclampsia (p=0.2).