Maternal and cord serum levels of sFlt-1 and PlGF in pregnancies complicated by gestational diabetes mellitus: a prospective cohort study.

Abstract

Introduction: Given the limited and conflicting evidence about maternal and fetal angiogenic/antiangiogenic factors in gestational diabetes mellitus (GDM) that exists in the known literature. The aim of this study is to evaluate the association of maternal and cord soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) serum levels and sFlt-1/PlGF ratios in normotensive pregnancies complicated by GDM.

Materials and methods: This prospective cohort study consists of 51 pregnant women diagnosed with GDM and 57 control groups. Maternal and cord serum sFlt-1 and PlGF levels were measured at 30th and 34th weeks of gestation and at the time of delivery. The maternal and cord sFlt-1/PlGF ratios were calculated. Obstetric and perinatal outcomes were evaluated.

Results: No significant differences were found in maternal serum levels of PlGF and sFlt-1 between the control and GDM groups (median 0.2 pg/mL vs. 0.2 pg/mL, p = .106; median 6.1 pg/mL vs. 5.27 pg/mL, p = .017, respectively); cord serum PlGF and sFlt-1 levels were significantly lower in the GDM group than control group (median 0.3 pg/mL vs. 0.2 pg/mL, p = .017; median 11.0 pg/mL vs. 8.1 pg/mL, p = .003, respectively). No significant difference was observed between maternal and cord serum sFlt-1/PlGF ratio (median 31.7 vs. 27.0 p = .394; median 29.0 vs. 26.9 p = .408, respectively). In pregnancies complicated by GDM and normal pregnancies, cord maternal/cord serum PlGF, sFlt-1 levels were not significantly associated with any of the variables such as fetal weight, body mass index (BMI), oral glucose tolerance test (OGTT) results, neonatal intensive care unit (NICU) admission and umbilical cord pH.

Conclusions: Results revealed that maternal sFlt-1, PlGF, and sFlt-1/PlGF ratios are not vital biomarkers of endothelial dysfunction and angiogenic imbalance in GDM, but low cord serum PlGF and sFlt-1 levels may reflect the chronic fetal hypoxia and increased placental angiogenesis in diabetic pregnancies.