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Independent risk factors for a small placenta and a small‐for‐gestational‐age infant at 35–41 weeks of gestation: An association with circulating angiogenesis‐related factor levels at 19–31 weeks of gestation
Author(s) -
Hirashima Chikako,
Ohkuchi Akihide,
Takahashi Kayo,
Suzuki Hirotada,
Shirasuna Koumei,
Matsubara Shigeki
Publication year - 2017
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13360
Subject(s) - medicine , placental growth factor , odds ratio , small for gestational age , placenta , gestation , obstetrics , gestational age , risk factor , angiogenesis , uterine artery , pregnancy , fetus , vascular endothelial growth factor , biology , vegf receptors , genetics
Aim Our aim was to investigate the effects of angiogenesis‐related factor levels at 19–25 and 26–31 weeks of gestation (WG) on the later occurrence of a small‐for‐gestational‐age (SGA) placenta (small placenta) or an SGA infant delivered at 35–41 WG. Methods We measured plasma levels of soluble fms‐like tyrosine kinase 1 (sFlt‐1) and placental growth factor (PlGF), and the serum level of soluble endoglin (sEng) in 679 pregnant women with blood sampling at both 19–25 and 26–31 WG in a prospective study. A small placenta and an SGA infant were defined as <10th percentile, respectively. Multivariate logistic regression analyses were performed using maternal factors, a high mean pulsatility index (high mPI) of the uterine artery in the second trimester, and angiogenesis‐related factor levels. Results Regarding the occurrence of a small placenta, low PlGF at 19–25 WG (adjusted odds ratio [95% confidence interval]: 2.4 [1.01–5.7]) and a high mPI (2.5 [1.4–4.3]) were independent risk factors. Moreover, low PlGF at 26–31 WG (3.3 [1.5–7.0]) was also an independent risk factor after adjusting for the effect of mPI. Concerning the occurrence of an SGA infant, a high mPI (2.8 [1.6–5.2]) and high sEng at 26–31 WG (2.3 [1.2–4.5]) were independent risk factors. Conclusion Low levels of PlGF at 19–25 and 26–31 WG were independent risk factors for a small placenta at ≥35 WG; and a high sEng at 26–31 WG was an independent risk factor for an SGA infant at ≥35 WG.