Early postpartum changes in circulating pro‐ and anti‐angiogenic factors in early‐onset and late‐onset pre‐eclampsia

Background. Pre‐eclampsia is associated with altered plasma concentrations of the pro‐ and anti‐angiogenic factors placental growth factor (PlGF), vascular endothelial growth factor‐A (VEGF‐A) and soluble fms‐like tyrosine kinase 1 (sFlt1). However, there is insufficient knowledge about how these concentrations change after delivery, and whether the changes differ between early‐onset and late‐onset pre‐eclampsia. Methods . Plasma concentrations of sFlt1, PlGF and VEGF‐A were measured before delivery and on days 1, 3 and 7 postpartum in women with early‐onset (24–32 weeks’ gestation) ( n = 18) and late‐onset pre‐eclampsia (35–42 weeks’ gestation) ( n = 20) and in control groups delivered in corresponding weeks of gestation. Results . All groups showed a rapid decrease in median sFlt1 concentration postpartum. Women with late‐onset pre‐eclampsia did not differ in sFlt1 concentration from controls on day 1 postpartum, whereas women with early‐onset pre‐eclampsia displayed a persistently elevated sFlt1 concentration on day 7 postpartum compared with controls. PlGF concentrations did not change from before delivery to any time point postpartum in the pre‐eclampsia groups. VEGF‐A concentrations were slightly increased on day 7 postpartum in both pre‐eclampsia and control groups compared to concentrations prior to delivery. Conclusion . Median sFlt1 concentrations decreased rapidly postpartum in all groups, but remained higher in early‐onset pre‐eclampsia than controls on day 7. Postpartum, the median PlGF concentrations were similar to the concentrations measured before delivery in women with pre‐eclampsia.