Lower placental growth factor and higher free -hCG and PAPP-A levels in the fetal circulation of near-term pregnancies complicated with severe preeclampsia

Background: An imbalance between anti- and angiogenic factors during early placentation is key for the development of preeclampsia. Nevertheless, the majority of studies addressing this issue relate to maternal blood and not the fetal circulation.Objective: To measure placental growth factor (PlGF), free beta human chorionic gonadotropin (-hCG), and pregnancy-associated plasma protein-A (PAPP-A) levels in the fetal circulation of near-term pregnancies complicated with severe preeclampsia (n=20), and their controls matched for parity, and maternal and gestational age.Method: Upon delivery, a blood sample was withdrawn from the umbilical artery and vein of each case and its control in order to measure the proposed analytes using direct fluoroimmunoassay.Results: Preeclampsia cases showed significantly lower median PlGF levels in fetal circulation as compared to controls (25.2 versus 36.9 and 23.6 versus 33.9pg/mL, artery and vein, respectively, p<0.05). Contrarily, cases displayed higher concentrations of PAPP-A (1024.0 versus 720.9 [median] and 1027.0298.4 versus 690.3401.9 mIU/L, artery and vein, respectively, p<0.05), and free -hCG (mean: 33.94.3 versus 17.24.0 and 30.15.2 versus 13.73.3ng/mL, artery, and vein respectively, p<0.05).Conclusion: Lower PlGF and higher PAPP-A and free -hCG levels were found in the fetal circulation of near-term severe preeclamptic pregnancies. There is a need for more research in this regard.