Maternal and cord steroid sex hormones, angiogenic factors, and insulin-like growth factor axis in African-American preeclamptic and uncomplicated pregnancies
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A history of a preeclamptic pregnancy has been associated with subsequent increased risk of cardiovascular disease in the mother and decreased risk of breast cancer in both the mother and offspring. The concentrations of steroid sex hormones, angiogenic factors, and other proteins during pregnancy are important components of the in utero environment and may mediate the association of preeclampsia with later health outcomes. This study sought to compare an extensive profile of biological markers in both maternal and umbilical cord samples in preeclamptic and uncomplicated pregnancies of a predominantly African-American population.
Steroid sex hormones, angiogenic factors, and components of the insulin-like growth factor axis were measured in maternal and umbilical cord sera from 48 pregnancies complicated by preeclampsia and 43 uncomplicated pregnancies. Regression models estimated the associations of these markers with preeclampsia, after adjusting for maternal and gestational age.
Concentrations of androgens (testosterone p = 0.06 and androstenedione p = 0.08) and the anti-angiogenic factors soluble fms-like kinase 1 (p = 0.004) and soluble endoglin (p = 0.004) were higher in the maternal circulation of women diagnosed with preeclampsia. These findings also were noted when the analyses were restricted to only African-American participants (77% of overall study population). Furthermore, among African-Americans, cord insulin-like growth factor-1 was lower in preeclamptic pregnancies than in controls.
The associations of maternal androgens and anti-angiogenic factors with preeclampsia are consistent with prior reports from predominantly Caucasian populations. Alterations in these analytes as well as other maternal and fetal biomarkers in preeclampsia could mediate the associations of preeclampsia with later health consequences.
KeywordsPreeclampsia African-American sFlt-1 IGF Leptin Prolactin
We would like to thank Lisa Philibert, RN and Kimberly Mandino, RN at LSUHSC-Shreveport for patient recruitment and clinical data collection for the study. We also thank Marianne Hyer and David Castenson at Information Management Systems for their contributions to data verification and analysis and Dr. Jun Zhang at NICHD for collaborating with us on the parent study. This research was supported in part by the intramural research program of the National Cancer Institute (NCI), National Institutes of Health and the Center for Cancer Training, Cancer Prevention Fellowship Program, NCI.
Conflict of interest
Dr. Karumanchi is a co-inventor on multiple patents related to use of angiogenic proteins for the diagnosis and therapeutic applications in preeclampsia. These patents are held by Beth Israel Deaconess Medical Center and have been licensed to multiple companies. Dr. Karumanchi has financial interest in Aggamin LLC.
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