Endothelial Progenitor Cells in Mothers of Low-Birthweight Infants: A Link between Defective Placental Vascularization and Increased Cardiovascular Risk?

Context: Offspring birthweight is inversely associated with future maternal cardiovascular mortality, a relationship that has yet to be fully elucidated. Endothelial progenitor cells (EPCs) are thought to play a key role in vasculogenesis, and EPC numbers reflect cardiovascular risk. Objective: Our objective was to ascertain whether EPC number or function was reduced in mothers of low-birthweight infants. Design and Setting: This was a prospective cohort study in a general antenatal department of a university maternity hospital. Participants: Twenty-three mothers of small for gestational age (SGA) infants (birthweight < 10th centile) and 23 mothers of appropriate for gestational age (AGA) infants (birthweight >= 10th centile) were recruited. Main Outcome Measures: Maternal EPC number and function, conventional cardiovascular risk markers, and cord blood adiponectin were measured. Results: Median EPC count was lower (294 vs. 367, P = 0.005) and EPC migration was reduced (0.91 vs. 1.59, P < 0.001) in SGA compared with AGA infants, with no difference in EPC adhesion (0.221 vs. 0.284 fluorescence units, P = 0.257). Maternal triglyceride levels were higher in SGA than AGA infants (0.98 vs. 0.78 mmol/liter, P = 0.006), but there was no difference in cholesterol, glucose, insulin, glycosylated hemoglobin, adiponectin, or blood pressure. There was a moderate monotone (increasing) relationship between birthweight and umbilical cord blood adiponectin (r = 0.475, P = 0.005). Conclusion: Giving birth to an SGA infant was associated with lower maternal EPC number and reduced migratory function. Cord blood adiponectin was significantly correlated with birthweight. (J Clin Endocrinol Metab 98: E33-E39, 2013)