Abstract
Objective
This study aimed at determining if first trimester serum biomarkers could predict
adverse pregnancy outcomes associated with villitis (VUE) and chronic intervillositis
of unknown etiology (CIUE).
Study design
Between January 2013 and June 2018, we selected from pathology department files placentas
with VUE or CIUE associated with VUE and control placentas with available first trimester
Down syndrome screening results. First trimester PAPP-A and βhCG levels were recorded.
Placental growth factor (PlGF) levels were measured in patients with an available
first trimester serum sample. Histological findings in placentas, course of pregnancies
and newborns’ characteristics were compared between cases and controls.
Results
78 cases and 75 controls were included. In cases, there were 21,8% intrauterine growth
restriction (IUGR), 30,8% small for gestational age (SGA). Compared to controls, placentas
from cases were smaller (425 g [IQR 370–480] vs 460 g [IQR 390–523], p = 0,03), showed more maternal vascular malperfusion features
(79,5% vs 22,7%, p < 0,0001) and more fetal vascular malperfusion features (33,3% vs 12%, p = 0,002). Cases had lower PlGF (29,74 pg/ml [IQR 19,74–36,17] vs 36,37 pg/ml [IQR 27,36–49,13], p = 0,007) and βhCG levels (0,74 MoM [IQR 0,53–1,12]
vs 1,00 MoM [IQR 0,72–1,53], p = 0,002) than controls. These differences resulted from
lower PlGF levels in VUE patients compared to CIUE associated with VUE patients and
controls (28,35 vs 34,05 and 36,37 pg/ml, p = 0,01) and from lower βhCG levels in CIUE associated with
VUE patients compared to VUE patients and controls (0,65 vs 0,86 and 1, p = 0,005).
Conclusion
Low first trimester PlGF levels in cases, especially in VUE patients, suggest that
reduced angiogenesis is involved in adverse pregnancy outcomes related to VUE.
Keywords
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Article info
Publication history
Published online: August 23, 2019
Accepted:
August 22,
2019
Received in revised form:
August 2,
2019
Received:
April 29,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
