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. 2014 Apr;90(4):195-200.
doi: 10.1016/j.earlhumdev.2014.01.003. Epub 2014 Jan 27.

Cord blood biomarkers of vascular endothelial growth (VEGF and sFlt-1) and postnatal growth: a preterm birth cohort study

Stephannie Baehl Voller  1 , Susanne Chock  2 , Linda M Ernst  3 , Emily Su  4 , Xin Liu  5 , Kathryn N Farrow  2 , Karen K Mestan  2
Affiliations

Cord blood biomarkers of vascular endothelial growth (VEGF and sFlt-1) and postnatal growth: a preterm birth cohort study

Stephannie Baehl Voller et al. Early Hum Dev. 2014 Apr.

Abstract

Background: Preterm infants are at risk for postnatal growth failure (PGF). Identification of biomarkers that are associated with neonatal growth may help reduce PGF and associated long-term morbidity.

Objective: To investigate the associations between cord blood vascular endothelial growth factor (VEGF) and its soluble receptor (sFlt-1) with birth weight (BW) and postnatal growth in premature infants.

Study design and methods: From an ongoing birth cohort, 123 premature infants from 23 to 36 weeks gestational age (GA) were studied. Cord blood plasma VEGF and sFlt-1 were measured via enzyme-linked immunoassay. Growth parameters and nutritional information were evaluated. Multivariate logistic regression models were constructed to evaluate the associations of VEGF and sFlt-1 on PGF, defined as weight <10th percentile at 36 weeks corrected age or discharge.

Results: VEGF was positively correlated, and sFlt-1 was negatively correlated with BW and BW-for-GA percentiles. Higher cord blood VEGF levels were associated with reduced risk of PGF (OR=0.7; 95% CI=0.5-0.9), while higher sFlt-1 levels appeared to increase the risk of PGF (OR=1.6; 95% CI=1.1-2.4). The above biomarker associations were attenuated after adjustment for maternal preeclampsia, fetal growth restriction and related neonatal characteristics, and when taking into account placental vascular pathologies. Longitudinal growth patterns by mean weight and length percentiles were consistently lower among infants with low VEGF/sFlt-1 ratios.

Conclusions: Our data support that intrauterine regulation of angiogenesis is an important mechanism of fetal and postnatal growth. Cord blood VEGF and sFlt-1 are useful in elucidating how intrauterine processes may have long-standing effects on developing premature infants.

Keywords: Birth weight; Cord blood; Fetal growth restriction; Fetal origins; Postnatal growth; Preterm infants; Vascular endothelial growth factor (VEGF).

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Conflict of interest statement

Conflict of interest statement:

The authors have no conflict of interest to disclose.

Figures

Figure 1
Figure 1
Postnatal growth percentiles of weight, length, and head circumference (occipital-frontal circumference, OFC) according to cord blood VEGF/sFlt-1 ratio. Low VEGF/sFlt-1 (1st quartile), normal ratio VEGF/sFlt-1 (2nd–3rd quartile), and high VEGF/sFlt-1 (4th quartile) shown. *P<0.05, low ratio vs. normal to high ratio percentile
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References

    1. Lemons JA, Bauer CR, Oh W, Korones SB, Papile L, Stoll BJ, et al. Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1995 through December 1996. Pediatrics. 2001;107(1) Available at: www.pediatrics.org/cgi/content/full/107/1/e1. - PubMed
    1. Ehrenkranz RA, Younes N, Lemons JA, Fanaroff AA, Donovan EF, Wright LL, et al. Longitudinal growth of hospitalized very low birth weight infants. Pediatrics. 1999;104(2):280–289. - PubMed
    1. Kamoji VM, Dorling JS, Manktelow BN, Draper ES, Field DJ. Extremely growth-retarded infants: is there a viability centile? Pediatrics. 2006;118:758–763. - PubMed
    1. Lundgren EM, Cnattingius S, Jonsson B, Tuvemo T, et al. Intellectual and psychological performance in males born small for gestational age with and without catch-up growth. Pediatr Res. 2001;50:91–96. - PubMed
    1. Leviton A, Fichorova RN, O’Shea M, Kuban K, Paneth N, Dammann O, Allred E. Two-hit model of brain damage in the very preterm newborn: small for gestational age and postnatal systemic inflammation. Pediatric Research. 2013;73(3):362–370. - PMC - PubMed

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