175 Perinatal Activity of Angiogenic Growth Factors in Intrauterine Growth Restriction

Abstract

Background: Vascular endothelial growth factor (VEGF) and placenta growth factor (PlGF) are expressed, among other organs, in the placenta and play cardinal roles in angiogenesis. Production of VEGF, in contrast to PlGF, is enhanced by hypoxia, which is present in intrauterine growth restriction (IUGR) pregnancies. This study aimed at investigating circulating VEGF and PlGF levels in maternal blood (MS) during the first stage of labor, in the doubly clamped umbilical cord (UC) at delivery, representing fetal state and in the neonate in the first (N1) and fourth (N4) day of life, reflecting transition and stabilization to extrauterine life, respectively. Methods: VEGF and PlGF were determined by enzyme immunoassay methods in serum, deriving from 15 fullterm appropriate for gestational age (AGA) and 15 fullterm IUGR infants, as well as from their mothers. Results: Statistical significant difference was noted in MS PlGF, being lower in IUGR as compared to AGA cases (p=0.014). Statistical significant correlations existed for VEGF between: UC and N1 (p=0.04), UC and N4 (p=0.011) and N1 and N4 (p=0.009) and for PlGF between N1 and N4 (p=0.018). In the IUGR group variables presenting a statistically significant association with: a) MS VEGF, were placental weight (p=0.031) and birth length (p=0.049), b) UC VEGF, was placental weight (p=0.016), c) N4 VEGF, were gestational age (p=0.028) and birth weight (p=0.026), d) UC PlGF, was head circumferance (p=0.036), e) N1 PlGF, was birth weight (p=0.023), f) N4 PlGF, was gestational age (p=0.011) and birth length (p=0.040). Conclusion: Low MS PlGF was associated with IUGR, while no differences were found between IUGR and AGA fetuses and neonates concerning PlGF and VEGF circulating levels. In IUGR fetuses VEGF is associated with placental weight, while in IUGR newborns with gestational age and birth weight. Similarly, PlGF in IUGR newborns is associated with gestational age and birth weight, in general reflecting the implication of angiogenic factors in angiogenesis and tissue growth.