Association of Low Placental Growth Factor Gene Expression with Maternal and Neonatal Outcomes in Type 1 Diabetes: A Single Center, Cross-Sectional Study

Abstract

Objective : The placental growth factor (PlGF) plays a crucial role in early and late pregnancy placental development. Pregestational type 1 diabetes (T1D) is a pregnancy complication that may lead to serious fetomaternal complications. Our study analyzed the association between placental PlGF mRNA expression and metabolic control, fetal weight and development in women with T1D. Materials and methods : A cross-sectional study on 65 pregnant women with T1D in singleton pregnancies admitted to the tertiary-level perinatal care unit. The study examined associations between the placental mRNA-PlGF gene expression measured with quantitative real-time PC and markers of maternal metabolism in the third trimester. The expression was also compared across maternal subgroups stratified according to the birth weight (small- vs. appropriate- vs. large-for-gestational age; SGA, AGA, LGA, respectively) and the following neonatal outcomes: mode of delivery, Apgar score and pH in the umbilical vessels. Results : Placental PlGF mRNA expression was significantly lower in SGA than in AGA and LGA patients (0.60 ± 0.34 vs. 0.63 ± 0.54 vs. 1.02 ± 0.15, respectively, p < 0.05). In the SGA group, the expression of the PlGF-mRNA correlated positively with maternal 3 rd trimester BMI (r = 0.49, p = 0.04), pH and BE cord blood values, and maternal 3 rd trimester mean BP. There was no correlation between 3 rd -trimester glycated hemoglobin and mean blood glucose levels (MBG) and PlGF expression. Conclusions : Our data suggest that lower PlGF mRNA expression may predict neonatal outcomes in women with T1D giving birth to SGA newborns.