Circulating angiogenic factors in gestational proteinuria without hypertension - 13/08/11
Reprints: Richard J. Levine, MD, Divison of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development, Department of Health and Human Services, Bethesda, MD 20892Résumé |
Objective |
Our goal was to determine whether obstetric outcomes and serum angiogenic factors are altered in women with gestational proteinuria without hypertension.
Study Design |
We performed a nested case-control study of 108 women with gestational proteinuria and compared them with 1564 randomly selected women with normotension without proteinuria during pregnancy (control subjects) and with 319 women who experienced preeclampsia.
Results |
Women with gestational proteinuria had greater body-mass index and higher blood pressure at study enrollment. Adverse obstetric outcomes were infrequent. Levels of free placental growth factor were lower than control levels beginning early in gestation. Compared with gestational-age matched control subjects, free placental growth factor was reduced beginning 6-8 weeks before proteinuria. Although soluble fms-like tyrosine kinase 1 and soluble endoglin concentrations were elevated 1-2 weeks before proteinuria, these elevations were modest and transient. After the onset of proteinuria, angiogenic factor levels generally did not differ significantly from control levels.
Conclusion |
Gestational proteinuria in healthy nulliparous women appears to be a mild variant of preeclampsia.
Le texte complet de cet article est disponible en PDF.Key words : angiogenic factor, gestational proteinuria, placental growth factor, preeclampsia, soluble endoglin, soluble fms-like tyrosine kinase 1
Plan
| This study was supported by funds and salary from the intramural research program of the National Institutes of Health and by salary from the US Navy; by the National Institute of Child Health and Human Development under contracts N01-HD-1-3121 through 3126, N01-HD-3154, and N01-HD-5-3246, with cofunding from the National Heart, Lung, and Blood Institute (Calcium for Preeclampsia Prevention trial database and specimen repository); and by National Institutes of Health Grants DK065997 and HL079594 (S.A.K., an investigator of the Howard Hughes Medical Institute). |
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| The views expressed are those of the authors and do not reflect the official policy or position of the Department of Defense or the US Government. |
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| Dr Karumanchi reports having served as a consultant to Abbott, Beckman Coulter, Roche, and Johnson & Johnson and having been named co-inventor on multiple provisional patents that were filed by Beth Israel Deaconess Medical Center for the use of angiogenesis-related proteins for the diagnosis and treatment of preeclampsia. These patents have been nonexclusively licensed to several companies. |
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| Cite this article as: Holston AM, Qian C, Yu KF, Epstein FH, Karumanchi SA, Levine RJ. Circulating angiogenic factors in gestational proteinuria without hypertension. Am J Obstet Gynecol 2009;200:392.e1-392.e10. |
Vol 200 - N° 4
P. 392.e1-392.e10 - avril 2009 Retour au numéro
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