Objective: Changes in maternal concentrations of the anti-angiogenic factors, soluble fms-like tyrosine kinase 1 (sFlt1) and soluble endoglin (sEng), and the pro-angiogenic placental growth factor (PlGF) precede the development of preeclampsia in healthy women. The risk of preeclampsia is reduced in women who smoke during pregnancy. The objective of this study was to investigate whether smoking affects concentrations of angiogenic factors (sFlt1, PlGF, and sEng) in women at high risk for developing preeclampsia.
Study Design: We performed a secondary analysis of serum samples from 993 high-risk women (chronic hypertension, diabetes, multifetal gestation, and previous preeclampsia) in a preeclampsia prevention trial. sFlt1, sEng and PlGF were measured in serum samples obtained at study entry, which was prior to initiation of aspirin (median 19.0 weeks' [interquartile range of 16.0–22.6 weeks']). Smoking status was determined by self-report.
Results: sFlt1 was not significantly different in smokers from any high-risk groups compared to their nonsmoking counterparts. PlGF was higher among smokers compared to nonsmokers among diabetic women (142.7 [77.4–337.3] vs 95.9 [48.5–180.7] pg/ml, p = 0.005) and women with a history of preeclampsia (252.2 [137.1–486.0] vs 152.2 [73.6–253.7] pg/ml, p = 0.001). sEng was lower in smokers with multifetal gestations (5.8 [4.6–6.5] vs 6.8 [5.5–8.7] ng/ml, p = 0.002) and trended lower among smokers with diabetes (4.9 [3.8–5.6] vs 5.3 [4.3–6.3] ng/ml, p = 0.05). Smoking was not associated with a lower incidence of preeclampsia in any of these groups.
Conclusions: In certain high-risk groups, smoking is associated with changes in the concentrations of these factors towards a pro-angiogenic direction during early pregnancy; however, there was no apparent association between smoking and the development of preeclampsia in our cohort.
Details
Title
Effect of Smoking on Circulating Angiogenic Factors in High Risk Pregnancies
Author
Jeyabalan, Arun : University of Pittsburgh Powers, Robert W. : University of Pittsburgh Clifton, Rebecca G. : George Washington University Van Dorsten, Peter : Medical University of South Carolina Hauth, John C. : University of Alabama at Birmingham Klebanoff, Mark A. : Eunice Kennedy Shriver National Institute of Child Health and Human Development Lindheimer, Marshall D. : University of Chicago Sibai, Baha : University of Tennessee Landon, Mark : The Ohio State University Miodovnik, Menachem : University of Cincinnati
Funding Information
Eunice Kennedy Shriver National Institute of Child Health and Human Development, HD19897 Eunice Kennedy Shriver National Institute of Child Health and Human Development, HD36801 Eunice Kennedy Shriver National Institute of Child Health and Human Development, HD21410 Eunice Kennedy Shriver National Institute of Child Health and Human Development, HD21414 Eunice Kennedy Shriver National Institute of Child Health and Human Development, HD21434 Eunice Kennedy Shriver National Institute of Child Health and Human Development, HD27860 Eunice Kennedy Shriver National Institute of Child Health and Human Development, HD27861 Eunice Kennedy Shriver National Institute of Child Health and Human Development, HD27869 Eunice Kennedy Shriver National Institute of Child Health and Human Development, HD27883 Eunice Kennedy Shriver National Institute of Child Health and Human Development, HD27889 Eunice Kennedy Shriver National Institute of Child Health and Human Development, HD27905 Eunice Kennedy Shriver National Institute of Child Health and Human Development, HD27915 Eunice Kennedy Shriver National Institute of Child Health and Human Development, HD27917 National Institutes of Health, 2P01-HD30367
Publication Date
2010-10-12
Language
English
Copyright Statement
This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.