Assessment of placental growth factor and soluble vascular endothelial growth factor receptor 1 in the prediction of pre-eclampsia

Background Pre-eclampsia is a pregnancy-associated disease occurring in 5-8% of pregnancies and is a major cause of maternal and fetal morbidity and mortality. A potentially important process in the pathogenesis of pre-eclampsia is an imbalance between placenta-derived proangiogenic and antiangiogenic proteins. The proangiogenic proteins vascular endothelial growth factor (VEGF) and placental growth factor (PLGF) are involved in the regulation of placental vascular development and maternal endothelial function during pregnancy. Aim of the study The aim of this study is to assess the PLGF and soluble vascular endothelial growth factor receptor 1 (sVEGFR-1) in the prediction of pre-eclampsia. Materials and methods This study included 88 pregnant women: 68 pregnant women with pre-eclampsia divided into two subgroups (mild and severe pre-eclampsia) and 20 healthy pregnant women matched for age and sex, who served as the control group. Laboratory investigations such as determination of complete blood count, blood urea, serum creatinine, aspartate aminotransferase, alanine transaminase, serum albumin, quantitative determination of total protein in urine, estimation of prothrombin time and concentration, serum PLGF concentration, and serum sVEGFR-1 concentrations were carried out by ELISA. BMI was estimated in this study. Results The results showed that serum PLGF was highly significant decreased in women with pre-eclampsia when compared with the control group. There was a highly statistically significant difference between mild and severe cases, where the PLGF decreased with increased severity of pre-eclampsia (P < 0.001). Serum sVEGFR-1 was highly significantly increased in women with pre-eclampsia when compared with the control group. There was a highly statistically significant difference between mild and severe cases, where the sVEGFR-1 increased with increased severity of pre-eclampsia (P < 0.001). ROC study showed that the best cutoff value for sVEGFR-1 was 2075 pg/ml and the sensitivity was 75%, whereas the specificity was 85%. The cutoff value for PLGF was 151 ng/ml; the sensitivity was 75%, whereas the specificity was 72.1%. There was a highly statistically significant negative correlation between PLGF and sVEGFR-1. Conclusion Finally, it is concluded that high concentrations of sVEGFR-1 combined with low concentrations of PLGF may be used to predict the development of pre-eclampsia. (C) 2012 The Egyptian Society of Haematology.