Angiogenic and inflammatory biomarkers in midpregnancy and small-for-gestational-age outcomes in Tanzania

• Published in: American journal of obstetrics and gynecology Vol. 211; no. 5; pp. 509.e1 - 509.e8
• Main Authors: Darling, Anne Marie, MSc, McDonald, Chloe R., MSc, Conroy, Andrea L., PhD, Hayford, Kyla T., PhD, Liles, W. Conrad, PhD, Wang, Molin, PhD, Aboud, Said, PhD, Urassa, Willy S., PhD, Kain, Kevin C., MD, Fawzi, Wafaie W., DrPH
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2014
• Subjects: Adolescent; Adult; angiogenesis; Angiopoietins - blood; Antigens, CD - blood; Biomarkers - blood; Birth Weight; C-Reactive Protein - metabolism; Complement System Proteins - metabolism; Cytokines - blood; Endoglin; Female; Fetal Growth Retardation - blood; Gestational Age; Humans; Infant, Newborn; Infant, Small for Gestational Age; inflammation; Inflammation - blood; Intercellular Adhesion Molecule-1 - blood; Leptin - blood; Multivariate Analysis; Neovascularization, Physiologic - physiology; Obstetrics and Gynecology; Placenta Growth Factor; Pregnancy; Pregnancy Proteins - blood; Pregnancy Trimester, First - blood; Pregnancy Trimester, Second - blood; Receptors, Cell Surface - blood; Receptors, Tumor Necrosis Factor, Type II - blood; Regression Analysis; small for gestational age; Tanzania; Vascular Endothelial Growth Factor A - blood; Vascular Endothelial Growth Factor Receptor-1 - blood; Young Adult; small for gestational age; inflammation; angiogenesis
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2014.05.032

Objective We sought to investigate the relationship between a panel of angiogenic and inflammatory biomarkers measured in midpregnancy and small-for-gestational-age (SGA) outcomes in sub-Saharan Africa. Study Design Concentrations of 18 angiogenic and inflammatory biomarkers were determined in 432 pregnant women in Dar es Salaam, Tanzania, who participated in a trial examining the effect of multivitamins on pregnancy outcomes. Infants falling below the 10th percentile of birthweight for gestational age relative to the applied growth standards were considered SGA. Multivariate binomial regression models with the log link function were used to determine the relative risk of SGA associated with increasing quartiles of each biomarker. Restricted cubic splines were used to test for nonlinearity of these associations. Results A total of 60 participants (13.9%) gave birth to SGA infants. Compared to those in the first quartile, the risk of SGA was reduced among those in the fourth quartiles of vascular endothelial growth factor-A (adjusted risk ratio [RR], 0.38; 95% confidence interval [CI], 0.19–0.74), placental growth factor (adjusted RR, 0.28; 95% CI, 0.12–0.61), soluble fms-like tyrosine kinase-1 (adjusted RR, 0.48; 95% CI, 0.23–1.01), monocyte chemoattractant protein-1 (adjusted RR, 0.48; 95% CI, 0.25–0.92), and leptin (adjusted RR, 0.46; 95% CI, 0.22–0.96). Conclusion Our findings provide evidence of altered angiogenic and inflammatory mediators, at midpregnancy, in women who went on to deliver SGA infants.