Circulating angiogenic factors in singleton vs multiple-gestation pregnancies

Maynard, Sharon E.; Simas, Tiffany A. Moore; Solitro, Matthew J.; Rajan, Anbarasan; Crawford, Sybil L.; Soderland, Peter; Meyer, Bruce A.

doi:10.1016/j.ajog.2007.08.042

Cited by 46 publications

(35 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A prospective study by Maynard et al [27] found that sFlt-1 concentration was two-fold higher in multiple gestations, compared with high-risk singleton pregnancies. sFlt-1 levels correlated with placental mass.…”

Section: Maternal Circulating Levels Of Angiogenic Factors and Risk Fmentioning

confidence: 97%

The perinatal implications of angiogenic factors

Smith

Wear

2009

Current Opinion in Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

show abstract

Section: Maternal Circulating Levels Of Angiogenic Factors and Risk Fmentioning

confidence: 97%

The perinatal implications of angiogenic factors

Smith

Wear

2009

Current Opinion in Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

show abstract

“…Circulating levels of sFlt-1 begin to rise before the onset of clinical symptoms (Levine et al 2004) and correlate with the severity of the disease (Chaiworapongsa et al 2004), suggesting important diagnostic and predictive potential (Cerdeira and Karumanchi 2010). Several risk factors for preeclampsia can also be correlated with increased sFlt-1 such as multigestational pregnancies (Bdolah et al 2008;Maynard et al 2008), hydatidiform mole (Koga et al 2010), trisomy 13 , and nulliparity . Potential additional contributors as a source of sFlt-1 besides trophoblasts include peripheral blood mononuclear cells ) and proteolytic shedding of extracellular fragment of Flt-1 in endothelial cells (Rahimi et al 2009;Zhao et al 2010), but the clinical significance of these sources is unknown.…”

Section: Preeclampsiamentioning

confidence: 99%

Angiogenic Factors in Preeclampsia and Related Disorders

Cerdeira

Karumanchi

2012

Cold Spring Harbor Perspectives in Medicine

100

View full text Add to dashboard Cite

“…Higher serum sFlt1 levels are observed in both of these groups, as compared with second pregnancies and singleton gestations, respectively. 36,37 Similarly, pregnant women whose fetuses are affected by trisomy 13 (a condition associated with increased preeclampsia risk) have higher circulating sFlt1 levels as compared with control subjects, 38 possibly as a result of the extra copy of the sFlt1 gene, which resides on chromosome 13. Smoking is associated with both a reduced risk for preeclampsia 39,40 and lower circulating sFlt1 levels in both pregnant 33,41 and nonpregnant 42 individuals, as compared with nonsmokers.…”

Section: Recent Advances In Preeclampsiamentioning

confidence: 99%

Pregnancy and the Kidney

Maynard¹,

Thadhani²

2009

Journal of the American Society of Nephrology

Self Cite

181

View full text Add to dashboard Cite

In recognizing renal disease, measurement of kidney function and proteinuria are the early standard bearers of subclinical pathology. With the dramatic hormonal and hemodynamic changes of pregnancy, renal function is altered and these changes must be considered when assessing renal function in pregnancy and in the choice of medications provided through parturition. Renal function and filtration are also affected in preeclampsia, and recent advances have greatly expanded our understanding of the pathophysiologic mechanisms of this pregnancy-specific renal syndrome. ASSESSMENT OF GFR AND PROTEINURIA DURING PREGNANCY Estimating GFR in PregnancyThe physiologic increase in GFR during pregnancy normally results in a decrease in concentration of serum creatinine, which falls by an average of 0.4 mg/dl to a pregnancy range of 0.4 to 0.8 mg/dl. 1 Hence, a serum creatinine of 1.0 mg/dl, although normal in a nonpregnant individual, reflects renal impairment in a pregnant woman. The Modification of Diet in Renal Disease (MDRD) formula, which estimates GFR using a combination of serum markers and clinical parameters, has become a standard clinical method to estimate renal function in patients with chronic kidney disease (CKD). The use of this formula has not been well studied in the pregnant population, and guidelines on application of the MDRD formula specifically exclude interpretation in pregnant women. Creatinine-based formulas developed in nonpregnant populations are likely to be inaccurate when applied to pregnant women. For example, the fall in serum creatinine during pregnancy reflects not only the pregnancy-induced increase in real GFR but also hemodilution resulting from the 30 to 50% plasma volume expansion by parturition. Perhaps more important, the MDRD formula systematically underestimates GFR as GFR rises above 60 ml/min per m 2 . This inherent inaccuracy is likely to be more pronounced at the high GFR of pregnancy.Weight-based formulas, such as Cockroft-Gault, might overestimate GFR because the increased body weight of pregnancy does not typically reflect increased muscle mass or creatinine production.In 2007, the accuracy of the MDRD formula in pregnant women was formally evaluated for the first time in two prospective studies. 2,3 Smith et al. 2 compared the performance of the modified MDRD formula (based on age, serum creatinine, and gender) with inulin clearance in three groups of women: healthy pregnant volunteers, women with preeclampsia, and pregnant women with CKD before pregnancy. Among healthy pregnant women, creatinine clearance by 24-h urine collection closely approximated GFR by inulin clearance; however, the MDRD underestimated GFR by Ͼ40 ml/min, a degree of bias that is somewhat higher than observed in nonpregnant kidney transplant donors with normal renal function (29 ml/min). 4 Among pregnant women with preeclampsia or CKD, the MDRD formula performed slightly better, underestimating GFR by 23.3 and 27.3 ml/min, respectively; however, the average GFR of all three groups Published online ahead ...

show abstract

Circulating angiogenic factors in singleton vs multiple-gestation pregnancies

Cited by 46 publications

References 29 publications

The perinatal implications of angiogenic factors

The perinatal implications of angiogenic factors

Angiogenic Factors in Preeclampsia and Related Disorders

Pregnancy and the Kidney

Contact Info

Product

Resources

About