The effect of prenatal multiple micronutrient supplementation on biomarkers of placental angiogenesis in rural Bangladesh (804.2)

Abstract

Prenatal multiple micronutrient (MM) supplementation improves birth weight through increased gestational age, yet it is unknown if improved placental function contributes to this effect. We assessed the effects of prenatal MM vs. iron and folic acid (IFA) on placental angiogenesis (the formation of blood vessels from existing ones) in a subset of women (n=395) participating in a double blinded, cluster‐randomized trial in rural Bangladesh. Angiogenic factors assessed in maternal plasma at 10 and 32 weeks gestation were placental growth factor (PlGF), angiopoietin 2 (Ang‐2), vascular endothelial growth factor (VEGF), and VEGF receptor 1 (VEGFR‐1). Concentrations were similar at baseline (10 weeks); PlGF, VEGF and VEGFR‐1 increased from the first to third trimester, whereas Ang‐2 decreased in both groups (p<0.01). At 32 weeks, PlGF and Ang‐2 were positively associated with gestational age and placental weight at birth and VEGFR‐1 was positively associated with placental weight (all p<0.05). Ang‐2 was 3.1 (95% CI: 0.20, 6.0) ng/mL higher at 32 weeks in mothers taking MM vs. IFA. There was no difference between MM and IFA groups in other angiogenic factors at 32 weeks, or their change from 10 to 32 weeks. MM supplementation improved angiogenic Ang‐2, reflective of enhanced placental vascular remodeling that may explain part of the MM impact on birth size through increased gestational age.Grant Funding Source: Supported by The Thrasher Research Fund, NIH (T32HD046405), The Gates Foundation, and USAID