Fetal Growth and Placental Growth Factor Umbilical Cord Blood Levels

Abstract

Objective: We assessed whether umbilical cord blood placental growth factor (PlGF) levels at delivery are associated with fetal growth. Methods: From a prospective population-based cohort study we included 3,461 live singleton births. Fetal growth was assessed by birth weight, fetal growth pattern, and fetal growth restriction (FGR; decrease in growth between the second trimester and birth of ≥40 percentiles). In all analyses the highest PlGF multiple of the median (MoM) quintile was used as the reference category. Results: Umbilical cord PlGF was neither correlated with maternal second-trimester PlGF (p = 0.08) nor placental weight (p = 0.18), suggesting that PlGF from umbilical cord blood was of fetal origin. Lower PlGF MoM quintiles were associated with a lower birth weight (lowest quintile -0.60 standard deviation [95% confidence interval -0.71 to -0.48, p for trend <0.001]) and a different fetal growth pattern (p < 0.001). Finally, lower PlGF MoM quintiles were associated with FGR (lowest quintile odds ratio 2.00 [95% confidence interval 1.25 to 3.21, p for trend <0.001]). Conclusion: Lower umbilical cord PlGF levels are associated with lower birth weight, deviating fetal growth patterns, and a higher odds of FGR. Hence, cord blood PlGF might be a promising biomarker to determine deviations in fetal growth and FGR retrospectively, enabling follow-up of these neonates.

Customized versus population birth weight charts for identification of newborns at risk of long-term adverse cardio-metabolic and respiratory outcomes: a population-based prospective cohort study

“…This would explain why we did not observe a clear benefit of customized charts over population charts for the identification of newborns at risk of adverse outcomes in later life. Future studies should determine whether customized charts can be improved by removal or addition of other parameters associated with fetal size and birth outcomes, such as parameters of placental vascular resistance or biomarkers [32, 33]. Second, it has been hypothesized that the observed stronger associations of abnormal fetal size or size at birth for gestational age based on customized charts with adverse perinatal outcomes could be explained by confounding, for example by preterm birth and maternal obesity [11].…”

Soluble fms-like tyrosine kinase 1 (sFlt-1) - a novel biochemical marker for acute fatty liver of pregnancy: a prospective observational study

“…Fetal growth restriction (FGR) was defined as fetal abdominal circumference <5th percentile or estimated fetal weight <10th percentile for gestational age with altered fetal and/or maternal hemodynamic or an abnormal growth trajectory over time. 20,21 We used the Swansea criteria as a diagnostic tool for AFLP. Patients were considered being positive if at least 6 criteria were present.…”

Alcoolisation fœtale

“…Concernant l'angiogenèse, les anomalies vasculaires observées à la suite d'une alcoolisation in utero aux niveaux du placenta et du cortex cérébral, pourraient être le fruit de processus concomitants mais indépendants. Toutefois, les constatations que 1) chez la souris, du PlGF circulant est retrouvé dans le sang céphalique foetal [30], 2) chez l'humain, des taux réduits de PlGF circulant dans le sang de cordon sont associés à des petits poids de naissance [45], et que 3) le placenta est une source majeure de PlGF au cours de la grossesse [46], ont renforcé l'hypothèse d'une contribution placentaire dans le contrôle de l'angiogenèse cérébrale foetale. Le premier argument en faveur d'un axe placenta/cerveau impliqué dans le contrôle de l'angiogenèse a été apportée chez l'humain par la démonstration d'une corrélation marquée entre les anomalies vasculaires placentaires et la désorganisation des microvaisseaux corticaux de foetus exposés in utero à l'alcool ( Figure 1F) [30].…”