The association between first trimester placental biomarkers and placental lesions of maternal vascular malperfusion.

Abstract

INTRODUCTION:

Abnormal levels of first trimester placental biomarkers are associated with the development of placental syndrome (PS). However, prediction performance is moderate, possibly explained by the clinical heterogeneity of PS. Aim of this study is to investigate the association between first trimester biomarkers and the presence of maternal vascular malperfusion (MVM), as a marker for placental insufficiency.

METHODS:

This retrospective study included 195 women with available first trimester blood sample and placenta histological sections for examination at the Maastricht University Medical Centre. Women were divided into 4 groups, based on the presence of having MVM lesions and/or PS. Levels of PAPP-A, PlGF and sFlt-1 were measured and MVM lesions were classified according to the Amsterdam Placental Workshop Group Consensus Statement.

RESULTS:

MVM occurrence was observed in 32% of the uncomplicated pregnancies. Women with MVM (regardless of the PS) had lower levels of PAPP-A (p = 0.038) and sFLt-1 (p = 0.006), and a non-significant trend for lower PlGF and sFlt-1/PlGF ratio compared to women without MVM. Low PAPP-A levels individually and in combination with the presence of PS was significantly associated with MVM lesions (aOR = 3.0 and 6.1, respectively), as did the combination of low PlGF levels and PS (aOR = 4.6). In women with PS, having MVM increased the incidence of fetal growth restriction, small for gestational age neonates, lower birthweight and adverse neonatal outcome.

DISCUSSION:

Our findings suggest that MVM lesions were found to be associated with increased obstetric risks due to early placental dysfunction that can potentially be predicted by the use of first trimester biomarkers.

• Authors: V M M M Schiffer, C W J Borghans, N Arts, J A P Bons, C A H Severens-Rijvers, S M J van Kuijk, M E A Spaanderman, S Al-Nasiry
• Journal: Placenta (Placenta) Vol. 103 Pg. 206-213 (01 01 2021) ISSN: 1532-3102 [Electronic] Netherlands
• PMID: 33161363 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

Chemical References

• Biomarkers

Topics

• Adult
• Biomarkers (analysis, metabolism)
• Cohort Studies
• Female
• Fetal Growth Retardation (epidemiology, metabolism, pathology, physiopathology)
• Humans
• Hypertension, Pregnancy-Induced (diagnosis, epidemiology, metabolism, physiopathology)
• Maternal-Fetal Exchange (physiology)
• Netherlands (epidemiology)
• Placenta (metabolism, pathology)
• Placenta Diseases (diagnosis, epidemiology, metabolism, physiopathology)
• Placental Circulation (physiology)
• Pregnancy
• Pregnancy Trimester, First (metabolism)
• Retrospective Studies
• Syndrome