TY - JOUR
T1 - Evidence in support of a role for anti-angiogenic factors in preterm prelabor rupture of membranes
AU - Savasan, Zeynep Alpay
AU - Romero, Roberto
AU - Chaiworapongsa, Tinnakorn
AU - Kusanovic, Juan Pedro
AU - Kim, Sun Kwon
AU - Mazaki-Tovi, Shali
AU - Vaisbuch, Edi
AU - Mittal, Pooja
AU - Ogge, Giovanna
AU - Madan, Ichchha
AU - Dong, Zhong
AU - Yeo, Lami
AU - Hassan, Sonia S.
PY - 2010/8
Y1 - 2010/8
N2 - Objective. Vaginal bleeding, placental abruption, and defective placentation are frequently observed in patients with preterm prelabor rupture of membranes (PROM). Recently, a role of vascular endothelial growth factor (VEGF) and its receptor, VEGF receptor (VEGFR)- 1 has been implicated in the mechanisms of membrane rupture. The purpose of this study was to determine whether the soluble form of VEGFR-1 and -2 concentrations in amniotic fluid (AF) change with preterm PROM, intra-amniotic infection/inflammation (IAI), or parturition. Study design.This cross-sectional study included 544 patients in the following groups: (1) midtrimester (MT) (n=48); (2) preterm labor (PTL) leading to term delivery (n=143); (3) PTL resulting in preterm delivery with (n=72) and without IAI (n=100); (4) preterm PROM with (n=46) and without IAI (n=42); (5) term in labor (n48); and (6) term not in labor (n=45). The concentrations of sVEGFR-1 and sVEGFR-2 were determined by ELISA. Non-parametric statistics and logistic regression analysis were applied. Results. (1) Preterm PROM (with and without IAI) had a lower median AF concentration of sVEGFR-1 than patients with PTL who delivered at term (p<0.001 for each comparison); (2) A decrease in AFsVEGFR-1 concentrations per each quartile was associated with PROM after adjusting for confounders (OR 1.8; 95%CI 1.4-2.3); (3) IAI, regardless of the membrane status, was not associated with a change in the median AF concentrations of sVEGFR-1 and sVEGFR-2 (p>0.05 for each comparison); and (4) Spontaneous term and PTL did not change the median sVEGFR-1 and sVEGFR-2 concentrations (p>0.05 for each comparison). Conclusion. (1) This is the first evidence that preterm PROM is associated with a lower AF concentration of sVEGFR-1 than patients with PTL intact membranes. These findings cannot be attributed to gestational age, labor, or IAI; and (2) AF concentrations of sVEGFR-2 did not change with preterm PROM, IAI, or labor at term and preterm.
AB - Objective. Vaginal bleeding, placental abruption, and defective placentation are frequently observed in patients with preterm prelabor rupture of membranes (PROM). Recently, a role of vascular endothelial growth factor (VEGF) and its receptor, VEGF receptor (VEGFR)- 1 has been implicated in the mechanisms of membrane rupture. The purpose of this study was to determine whether the soluble form of VEGFR-1 and -2 concentrations in amniotic fluid (AF) change with preterm PROM, intra-amniotic infection/inflammation (IAI), or parturition. Study design.This cross-sectional study included 544 patients in the following groups: (1) midtrimester (MT) (n=48); (2) preterm labor (PTL) leading to term delivery (n=143); (3) PTL resulting in preterm delivery with (n=72) and without IAI (n=100); (4) preterm PROM with (n=46) and without IAI (n=42); (5) term in labor (n48); and (6) term not in labor (n=45). The concentrations of sVEGFR-1 and sVEGFR-2 were determined by ELISA. Non-parametric statistics and logistic regression analysis were applied. Results. (1) Preterm PROM (with and without IAI) had a lower median AF concentration of sVEGFR-1 than patients with PTL who delivered at term (p<0.001 for each comparison); (2) A decrease in AFsVEGFR-1 concentrations per each quartile was associated with PROM after adjusting for confounders (OR 1.8; 95%CI 1.4-2.3); (3) IAI, regardless of the membrane status, was not associated with a change in the median AF concentrations of sVEGFR-1 and sVEGFR-2 (p>0.05 for each comparison); and (4) Spontaneous term and PTL did not change the median sVEGFR-1 and sVEGFR-2 concentrations (p>0.05 for each comparison). Conclusion. (1) This is the first evidence that preterm PROM is associated with a lower AF concentration of sVEGFR-1 than patients with PTL intact membranes. These findings cannot be attributed to gestational age, labor, or IAI; and (2) AF concentrations of sVEGFR-2 did not change with preterm PROM, IAI, or labor at term and preterm.
KW - MIAC
KW - SKDR
KW - SVEGFR-1
KW - SVEGFR-2
KW - amniotic fluid
KW - angiogenesis
KW - chorioamnionitis
KW - intraamniotic infection
KW - intraamniotic inflammation
KW - microbial invasion of the amniotic cavity
KW - parturition
KW - prematurity
KW - preterm PROM
KW - preterm labor
KW - sflt-1
KW - term labor
UR - http://www.scopus.com/inward/record.url?scp=77954727002&partnerID=8YFLogxK
U2 - 10.3109/14767050903440471
DO - 10.3109/14767050903440471
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C2 - 20158393
AN - SCOPUS:77954727002
SN - 1476-7058
VL - 23
SP - 828
EP - 841
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 8
ER -