OP 14 Angiogenic factors in pregnancies complicated by rheumatoid arthritis

Abstract

Introduction Women with active rheumatoid arthritis (RA) during pregnancy deliver often infants with reduced birth weight. We hypothesized that RA might have an impact on placental function and subsequently on the angiogenic profile. Objectives We aimed to investigate the pro- and anti-angiogenic factors such as placental growths factor (PLGF) and soluble fms-like tyrosine kinase-1 (sFlt-1), respectively, in patients with RA and healthy controls. Patients and methods PLGF and sFlt-1 serum levels of pregnant patients with RA ( n = 29) and gestational aged-matched healthy women ( n = 10) were analyzed once at each trimester (gestational week 10–12, 20–22 and 30–32). Disease activity of all RA patients was measured by DAS28-CRP and CRP. Neonatal birth weights and birth weight percentiles were correlated with PLGF and sFlt-1- levels. Results Median birth weight of the newborns from RA patients was 2730 g (range 1250–4000). Among all pregnancies of RA patients, the levels of PLGF and sFlt-1 were similar in active and inactive disease. At the third trimester of pregnancy, RA patients showed lower levels of the pro-angiogenic placental protein PLGF than healthy controls ( p = 0.011). In contrast, levels of the anti-angiogenic protein sFLT-1 did not differ between RA patients and healthy women. The sFlt-1/PLGF ratio was lower in healthy women than in RA patients ( p = 0.020). Moreover the sFlt-1/PLGF ratio correlated negatively with the birth weight percentile. Conclusions RA patients showed reduced levels of the angiogenic placental protein PLGF irrespective of disease activity. The reduced PLGF levels in RA patients might reflect a dysfunction of the placenta which in turn could have an effect on birth weight.