Longitudinal circulating placental growth factor (PlGF) and soluble FMS-like tyrosine kinase-1 (sFlt-1) concentrations during pregnancy in Asian women: a prospective cohort study

• Published in: BMJ open Vol. 9; no. 5; p. e028321
• Main Authors: Ng, Qiu Ju, Han, Jonathan Youxiang, Saffari, Seyed Ehsan, Yeo, George Seow-Heong, Chern, Bernard Su Min, Tan, Kok Hian
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.05.2019; BMJ Publishing Group
• Subjects: Cohort analysis; Health risk assessment; Medical diagnosis; Obstetrics and Gynaecology; Preeclampsia; Pregnancy; Trends; Vascular endothelial growth factor; Womens health; Singapore; prenatal diagnosis; pre-eclampsia; placental biomarkers
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2018-028321

ObjectivesTo analyse the placental growth factor (PlGF) and soluble FMS-like tyrosine kinase-1 (sFlt-1) trends in the normal pregnant Asian population in Singapore.DesignA prospective study was conducted.SettingThe largest tertiary hospital in Singapore.MethodsWomen with single viable pregnancies, less than 14 weeks of gestation, were recruited between September 2010 and November 2013 in KK Women’s and Children’s Hospital. They were followed up from recruitment till their postnatal discharge from the hospital. There were four antenatal visits: gestational age (GA) less than 14+0 weeks of gestation (V1), GA 18+0 to 22+0 weeks (V2), GA 28+0 to 32+0 weeks (V3) and GA 34+0 and above (V4). Serum biochemical markers (sFlt-1, PlGF) were measured at each visit.ResultsThere were 934 participants in the study, of which 674 had normal pregnancy outcomes. The sFlt-1 remained relatively constant till GA 28–32 weeks before it increased (p<0.001). The sFlt-1 levels increased earlier before 30 weeks’ of gestation among the Malay participants and the other ethnicities. For PlGF, the levels increased from the first to the third trimester, peaking at 30–32 weeks before decreasing (p<0.001). Its serum levels significantly differed among the Indian participants and other ethnicities as compared with the Malay and Chinese participants at V3 and V4, (p=0.04 and p<0.001, respectively).ConclusionThere are significant differences in the PlGF and sFlt-1 concentrations during pregnancy between different ethnicities, which should be taken into consideration when using these references values for further research.