TY - JOUR
T1 - First trimester angiogenic and inflammatory factors in women with chronic hypertension and impact of blood pressure control
T2 - a case–control study
AU - Nzelu, D.
AU - Nicolaides, K. H.
AU - Kametas, N. A.
N1 - Funding Information:
The study was funded by the Fetal Medicine Foundation (Registered charity No. 1037116). The reagents and equipment for the measurement of serum placental growth factor and soluble fms‐like tyrosine kinase‐1 were provided by Thermo Fisher Scientific. These bodies had no involvement in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.
Publisher Copyright:
© 2021 John Wiley & Sons Ltd.
PY - 2021/12
Y1 - 2021/12
N2 - Objectives: To assess first trimester serum placental growth factor (PLGF), soluble fms-like tyrosine kinase-1 (sFLT-1), interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), endothelin and vascular cell adhesion molecule (VCAM) in women with chronic hypertension (CH) stratified according to blood pressure (BP) control. Design: Case–control. Setting: Tertiary referral centre. Population: 650 women with CH, 142 normotensive controls. Methods: In the first trimester, patients with CH were subdivided into four groups. Group 1 included women without pre-pregnancy CH presenting with BP ≥140/90 mmHg. Groups 2–4 had pre-pregnancy CH; in group 2 the BP was <140/90 mmHg without antihypertensive medication, in group 3 the BP was <140/90 mmHg with antihypertensive medication, and in group 4 the BP was ≥140/90 mmHg despite antihypertensive medication. PLGF, sFLT-1, IL-6, TNF-α, endothelin and VCAM were measured at 11+0–13+6 weeks’ gestation and converted into multiples of the expected median (MoM) using multivariate regression analysis in the controls. Main outcome measure: Comparisons of MoM values of PLGF, sFLT-1, endothelin, IL-6, TNF-α and VCAM between the entire cohort of women with CH and the control group were made using Student’s t-test or Mann–Whitney U-test. Comparisons between the four CH groups were made using analysis of variance or Kruskal–Wallis tests. Results: Compared with the control group, women with CH had significantly lower MoM of PLGF, sFLT-1 and IL-6 and a significantly higher MoM of endothelin. Between the four groups of women with CH, there were no significant differences in the MoM of sFLT-1, PLGF, sFLT-1/PLGF ratio, endothelin, IL-6 or VCAM, or in the levels of TNF- α. Conclusion: In women with CH, differences exist in first trimester angiogenic and inflammatory profiles when compared with normotensive pregnancies. However, these differences do not assist in the stratification of women with CH to identify those with more severe underlying disease and worse pregnancy outcomes. Tweetable abstract: First trimester blood pressure control impacts on serum PLGF, sFLT-1, endothelin and IL-6 in women with chronic hypertension.
AB - Objectives: To assess first trimester serum placental growth factor (PLGF), soluble fms-like tyrosine kinase-1 (sFLT-1), interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), endothelin and vascular cell adhesion molecule (VCAM) in women with chronic hypertension (CH) stratified according to blood pressure (BP) control. Design: Case–control. Setting: Tertiary referral centre. Population: 650 women with CH, 142 normotensive controls. Methods: In the first trimester, patients with CH were subdivided into four groups. Group 1 included women without pre-pregnancy CH presenting with BP ≥140/90 mmHg. Groups 2–4 had pre-pregnancy CH; in group 2 the BP was <140/90 mmHg without antihypertensive medication, in group 3 the BP was <140/90 mmHg with antihypertensive medication, and in group 4 the BP was ≥140/90 mmHg despite antihypertensive medication. PLGF, sFLT-1, IL-6, TNF-α, endothelin and VCAM were measured at 11+0–13+6 weeks’ gestation and converted into multiples of the expected median (MoM) using multivariate regression analysis in the controls. Main outcome measure: Comparisons of MoM values of PLGF, sFLT-1, endothelin, IL-6, TNF-α and VCAM between the entire cohort of women with CH and the control group were made using Student’s t-test or Mann–Whitney U-test. Comparisons between the four CH groups were made using analysis of variance or Kruskal–Wallis tests. Results: Compared with the control group, women with CH had significantly lower MoM of PLGF, sFLT-1 and IL-6 and a significantly higher MoM of endothelin. Between the four groups of women with CH, there were no significant differences in the MoM of sFLT-1, PLGF, sFLT-1/PLGF ratio, endothelin, IL-6 or VCAM, or in the levels of TNF- α. Conclusion: In women with CH, differences exist in first trimester angiogenic and inflammatory profiles when compared with normotensive pregnancies. However, these differences do not assist in the stratification of women with CH to identify those with more severe underlying disease and worse pregnancy outcomes. Tweetable abstract: First trimester blood pressure control impacts on serum PLGF, sFLT-1, endothelin and IL-6 in women with chronic hypertension.
KW - Angiogenic factors
KW - blood pressure
KW - chronic hypertension
KW - endothelin
KW - first trimester
KW - inflammatory mediators
KW - interleukin-6
KW - placental growth factor
KW - pre-eclampsia
KW - pregnancy
KW - soluble fms-like tyrosine kinase-1
KW - tumour necrosis factor-α
KW - vascular cell adhesion molecule
UR - http://www.scopus.com/inward/record.url?scp=85111838259&partnerID=8YFLogxK
U2 - 10.1111/1471-0528.16835
DO - 10.1111/1471-0528.16835
M3 - Article
C2 - 34245653
AN - SCOPUS:85111838259
SN - 1470-0328
VL - 128
SP - 2171
EP - 2179
JO - BJOG
JF - BJOG
IS - 13
ER -