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Do patients with a history of pre-eclampsia have elevated levels of coagulation and angiogenic markers postpartum?

Do patients with a history of pre-eclampsia have elevated levels of coagulation and angiogenic markers postpartum?
Do patients with a history of pre-eclampsia have elevated levels of coagulation and angiogenic markers postpartum?
Background: Pre-eclampsia (P-EC) is a pregnancy-specific disorder, characterised by placental insufficiency and endothelial dysfunction. It is a significant cause of maternal and fetal morbidity. Women with a history of P-EC have heightened risks of future cardiovascular and thromboembolic disease. In addition, pre-eclamptic patients have elevated levels of clotting and angiogenic factors; however it is unclear whether these changes persist postpartum.

Aims: The aim of this study was to investigate the relationship between haemostatic as well as angiogenic and anti-angiogenic factors in women with a past-history of P-EC, including vascular endothelial growth factor (VEGF), placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng), in combination with tissue factor (TF) and TF pathway inhibitor (TFPI), also whether these factors were altered postpartum in women with a history of P-EC.

Methods: The study followed a case-control design. Blood samples were obtained at 6-12 months postpartum from 21 primiparous women after a pregnancy affected by P-EC, and 21 women with a previously unaffected pregnancy. Plasma concentrations of each of the factors were determined using enzyme-linked immunosorbent assay.

Results: Significant differences were not observed in levels of VEGF (p=0.068), PlGF (p=0.333), sFlt-1 (p=0.910), sEng (p=0.612), TF (p=0.260) or TFPI (p=0.786) between women with and without a history of pre-eclampsia. Additionally, no significant difference was found in the TF: TFPI ratio between case and control groups (p=0.734).

Conclusion: This study does not support the hypothesis that levels of VEGF, PlGF, sFlt-1, sEng, TF or TFPI are altered in women with a history of P-EC compared to controls. However, we observed a weak positive association between all parameters measured. While we acknowledge that this is a pilot study and that the sample sizes is relatively small, our results suggest that circulating haemostatic, angiogenic and anti-angiogenic factors are not significantly altered in women with a past-history of P-EC
2639-9342
Abad, Fatma
46a6b496-747d-42af-8cdc-ff01964485fd
Birch, Brian
8a94cd36-d429-4ab4-82a6-a376b4d4e10f
van Rijn, Bas B.
f5b6bd81-2421-416d-b9a9-9c0857e94e6a
Lwaleed, Bashir
e7c59131-82ad-4a14-a227-7370e91e3f21
Abad, Fatma
46a6b496-747d-42af-8cdc-ff01964485fd
Birch, Brian
8a94cd36-d429-4ab4-82a6-a376b4d4e10f
van Rijn, Bas B.
f5b6bd81-2421-416d-b9a9-9c0857e94e6a
Lwaleed, Bashir
e7c59131-82ad-4a14-a227-7370e91e3f21

Abad, Fatma, Birch, Brian, van Rijn, Bas B. and Lwaleed, Bashir (2021) Do patients with a history of pre-eclampsia have elevated levels of coagulation and angiogenic markers postpartum? Gynecology and Reproductive Health. (In Press)

Record type: Article

Abstract

Background: Pre-eclampsia (P-EC) is a pregnancy-specific disorder, characterised by placental insufficiency and endothelial dysfunction. It is a significant cause of maternal and fetal morbidity. Women with a history of P-EC have heightened risks of future cardiovascular and thromboembolic disease. In addition, pre-eclamptic patients have elevated levels of clotting and angiogenic factors; however it is unclear whether these changes persist postpartum.

Aims: The aim of this study was to investigate the relationship between haemostatic as well as angiogenic and anti-angiogenic factors in women with a past-history of P-EC, including vascular endothelial growth factor (VEGF), placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng), in combination with tissue factor (TF) and TF pathway inhibitor (TFPI), also whether these factors were altered postpartum in women with a history of P-EC.

Methods: The study followed a case-control design. Blood samples were obtained at 6-12 months postpartum from 21 primiparous women after a pregnancy affected by P-EC, and 21 women with a previously unaffected pregnancy. Plasma concentrations of each of the factors were determined using enzyme-linked immunosorbent assay.

Results: Significant differences were not observed in levels of VEGF (p=0.068), PlGF (p=0.333), sFlt-1 (p=0.910), sEng (p=0.612), TF (p=0.260) or TFPI (p=0.786) between women with and without a history of pre-eclampsia. Additionally, no significant difference was found in the TF: TFPI ratio between case and control groups (p=0.734).

Conclusion: This study does not support the hypothesis that levels of VEGF, PlGF, sFlt-1, sEng, TF or TFPI are altered in women with a history of P-EC compared to controls. However, we observed a weak positive association between all parameters measured. While we acknowledge that this is a pilot study and that the sample sizes is relatively small, our results suggest that circulating haemostatic, angiogenic and anti-angiogenic factors are not significantly altered in women with a past-history of P-EC

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More information

Accepted/In Press date: 6 August 2021

Identifiers

Local EPrints ID: 452656
URI: http://eprints.soton.ac.uk/id/eprint/452656
ISSN: 2639-9342
PURE UUID: d5e4ccec-062e-4321-b435-e44ef1e46ec1

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Date deposited: 11 Dec 2021 11:31
Last modified: 12 Dec 2021 16:20

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Contributors

Author: Fatma Abad
Author: Brian Birch
Author: Bas B. van Rijn
Author: Bashir Lwaleed

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