Prognostic value of angiogenic markers in pregnant women with chronic hypertension

Download

JAHA.120.020631.pdf

Date

2021-09-07

Author

Binder, Julia
Palmrich, Pilar
Kalafat, Erkan
Pateisky, Petra
Oeztuerk, Ebru
Mittelberger, Johanna
Khalil, Asma

Metadata

Show full item record

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Item Usage Stats

229
views

51
downloads

Women with chronic hypertension face a 5-to 6-fold increased risk of developing preeclampsia compared with normotensive women. Angiogenic markers, especially soluble fms-like kinase 1 (sFlt-1) and placental growth factor (PlGF), were identified as clinically useful markers predicting the development of preeclampsia, but data on the prediction of superimposed preeclampsia are scarce. Therefore, we aimed to evaluate the predictive value of the sFlt-1/PlGF ratio for delivery because of superimposed preeclampsia in women with chronic hypertension. METHODS AND RESULTS: This retrospective study included 142 women with chronic hypertension and suspected superimposed preeclampsia. Twenty-seven women (19.0%) delivered because of maternal indications only, 17 women (12.0%) because of fetal indications primarily, and 98 women (69.0%) for other reasons. Women who both delivered because of maternal indications and for fetal indications had a significantly higher sFlt-1/PlGF ratio (median 99.9 and 120.2 versus 7.3, respectively, P<0.001 for both) and lower PlGF levels (median 73.6 and 53.3 versus 320.0 pg/mL, respectively, P<0.001 for both) compared with women who delivered for other reasons. SFlt-1/PlGF ratio and PlGF were strong predictors for delivery because of superimposed preeclampsia, whether for maternal or fetal indications (P<0.05). Half of women with angiogenic imbalance (sFlt-1/PlGF ratio ≥85 or PlGF levels <100 pg/mL) delivered because of maternal or fetal indications within 1.6 weeks (95% CI, 1.0–2.4 weeks). CONCLUSIONS: Angiogenic marker imbalance in women with suspected superimposed preeclampsia can predict delivery because of maternal and fetal indications related to superimposed preeclampsia and is associated with a significantly shorter time to delivery interval.

Subject Keywords

angiogenic markers, chronic hypertension, preeclampsia, superimposed preeclampsia, SUPERIMPOSED PREECLAMPSIA, SFLT-1PLGF RATIO, PREDICTIVE-VALUE, ONSET, RISK, Angiogenic markers, Chronic hypertension, Preeclampsia, Superimposed preeclampsia

URI

https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85115218908&origin=inward
https://hdl.handle.net/11511/94667

Journal

Journal of the American Heart Association

DOI

https://doi.org/10.1161/jaha.120.020631

Collections

Department of Statistics, Article

Suggestions

OpenMETU
Core

Angiogenic markers and their longitudinal change for predicting adverse outcomes in pregnant women with chronic hypertension Binder, Julia; Kalafat, Erkan; Palmrich, Pilar; Pateisky, Petra; Khalil, Asma (2021-09-01) Background: Women with chronic hypertension are at increased risk for adverse maternal and perinatal outcomes. Maternal serum angiogenic markers, such as soluble fms-like tyrosine kinase 1 and placental growth factor, can be used to triage women with suspected preeclampsia. However, data about these markers in pregnant women with chronic hypertension are scarce. Objective: We aimed to evaluate the predictive accuracy of maternal serum levels of soluble fms-like tyrosine kinase 1, placental growth factor, an...
Prognostic Value of Maternal Cardiovascular Hemodynamics in Women With Gestational Hypertension and Chronic Hypertension in Pregnancy Kalafat, Erkan; Perry, Helen; Bowe, Sophie; Thilaganathan, Basky; Khalil, Asma (Ovid Technologies (Wolters Kluwer Health), 2020-08-01) This study aimed to assess the prognostic value of cardiovascular assessment in women with gestational hypertension or chronic hypertension for the risk of preeclampsia and need for closer antenatal surveillance. This was a prospective study of pregnancies complicated by gestational hypertension or chronic hypertension presenting to St George's Hospital, between January 2015 and May 2018. A noninvasive ultrasonic cardiac output monitor was used to obtain cardiovascular variables of cardiac output (CO) and s...
Should angiogenic markers be included in diagnostic criteria of superimposed pre-eclampsia in women with chronic hypertension? Binder, J.; Kalafat, Erkan; Palmrich, P.; Pateisky, P.; Khalil, A. (2022-02-01) Objective Although the most recent guidance from the International Society for the Study of Hypertension in Pregnancy (ISSHP) has highlighted the role of angiogenic marker assessment in the diagnosis of pre-eclampsia (PE) in women with chronic hypertension, the ISSHP has withheld recommending its implementation due to the limited available evidence in this group of women. Therefore, we aimed to investigate the value of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) assessment...
Incidence of postpartum hypertension within 2 years of a pregnancy complicated by pre-eclampsia: a systematic review and meta-analysis Giorgione, V; Ridder, A.; Kalafat, E.; Khalil, A.; Thilaganathan, B. (Wiley, 2020-10-01) Background Women with a history of hypertensive disorders of pregnancy (HDP) are at increased long-term risk of cardiovascular disease. However, there has been increasing evidence on the same risks in the months following birth. Objectives This review aims to estimate the incidence of hypertension in the first 2 years after HDP. Search strategy MEDLINE, Embase and Cochrane databases were systematically searched in October 2019. Selection criteria Observational studies comparing hypertension rate following H...
Metformin for prevention of hypertensive disorders of pregnancy in women with gestational diabetes or obesity: systematic review and meta-analysis of randomized trials KALAFAT, ERKAN; ŞÜKÜR, YAVUZ EMRE; Abdi, A.; Thilaganathan, B.; Khalil, A. (2018-12-01) Objective Metformin has been reported to reduce the risk of pre-eclampsia. It is also known to influence soluble fms-like tyrosine kinase-1 level, which correlates significantly with the gestational age at onset and severity of pre-eclampsia. The main aim of this systematic review and meta-analysis of randomized trials was to determine whether metformin use is associated with the incidence of hypertensive disorders of pregnancy (HDP).

Citation Formats

J. Binder et al., “Prognostic value of angiogenic markers in pregnant women with chronic hypertension,” Journal of the American Heart Association, vol. 10, no. 17, pp. 0–0, 2021, Accessed: 00, 2021. [Online]. Available: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85115218908&origin=inward.