Angiogenic profile in the Finnish Genetics of Pre-Eclampsia Consortium (FINNPEC) cohort

Objectives: To study first and second/third trimester levels of soluble fms-like tyrosine kinase 1 (sFlt1), placental growth factor (PlGF) and soluble endoglin (sEng) in FINNPEC case-control cohort. The participants were further divided into subgroups based on parity and onset of the disease. Recommended cut-off values in aid of pre-eclampsia (PE) prediction and diagnosis were also tested. Methods: First trimester serum samples were available from 221 women who later developed PE and 239 women who did not develop PE. Second/third trimester serum samples were available from 175 PE and 55 non-PE women. sFl1-1 and PlGF were measured electro-chemiluminescence immunoassays and sEng by ELISA. Results: In all timepoints PlGF, endoglin and the sFlt-1/PlGF ratio were increased in the PE group compared to the non-PE group. The serum concentrations of sFlt-1 were increased only a second/third trimester in PE women. Higher concentrations of s-Flt1, endoglin and higher sFlt/PlGF ratio were found a the third trimester in primiparous women compared to multiparous women. Primiparous PE women also had lower concentrations of PlGF a the third trimester. The proportion of women exceeding all cut-offs of the sFlt-1/PlGF ratio (>= 33, >= 38, >= 85 and >= 110) was greater in the PE group, but there were also pre-eclamptic women who met rule-out cut-off or did no meet rule-in cut-off. Conclusions: Primiparous pregnancies have more anti-angiogenic profile during second/third trimester compared with multiparous pregnancies. Our findings also suggest that certain maternal characteristics, e.g. BMI, smoking and pre-existing diseases, should be taken into account when different sFlt-1/PlGF ratio cut-offs are utilized.