41 Placental growth factor and severity of preeclampsia

Abstract

Introduction Many markers have been studied to improve the understanding of preeclampsia (PE) pathophysiology. PlGF stands out as an important marker to predict PE. We hypothesized that PlGF could be associated with the severity of the disease. Objectives To analyze PlGF levels in maternal plasma in normotensive and preeclamptic women, in the third trimester of pregnancy, and evaluate severity parameters in PE group with levels of PlGF, and correlate PlGF levels with maternal and fetal variables. Methods Case-control study that included 117 pregnant women (50 with PE and 67 in the control group). After consent of the patients, maternal plasma samples were collected and stocked at −80°C until the time of the analysis. The PlGF was quantified using MagPlexTH-C microspheres system and analyzed using ANCOVA adjusted by body mass index, gestational age (GA) and maternal age. PE group was stratified in relation to GA (cut point in 34wks) and proteinuria levels (proteinuria/creatininuria ratio – P/C, cut point in 0.5). Variables as newborn and placental weight; systolic and diastolic blood pressure were correlated to PlGF levels. To estimate the difference between groups, mean ratio (MR) and confidence interval (CI) of 95% was calculated. Analysis between PlGF levels were made by Pearson correlation. The null hypothesis was rejected when p Results There was a 62% reduction of PlGF levels in pregnant women with PE (excluding superimposed PE and HELLP Syndrome) in relation to the control group (MR=0,38; CI 95%: 0.15–0.95; p =0.041). When the PE group was stratified, PlGF levels were significantly lower in the group with PE with GA p =0.018), and those with P/C⩾0.5 vs. P/C p =0.027). It was also observed a correlation between PlGF levels and the newborn and placenta weight ( r =0.510, p r =0.331, p r =−0.352, p r =−0.360, p Conclusion It was found that the PlGF levels were significantly reduced in maternal plasma when GA 0.5. Also, it was observed a direct correlation between PlGF and weight of placenta and the newborn, and a negative correlation with blood pressure. Thus, in view of the findings presented, the question is if PlGF besides being studied with focus on the prediction of PE, could also be inserted in the context of the disease severity.