Association of pregnancy‑associated plasma protein A and vascular endothelial growth factor with pregnancy‑induced hypertension

Zhang,Zhengzheng; Xu,Hao; Liu,Xiao; Li,Pan; Du,Wensheng; Han,Qiuyu

doi:10.3892/etm.2019.7724

Association of pregnancy‑associated plasma protein A and vascular endothelial growth factor with pregnancy‑induced hypertension

Authors:
- Zhengzheng Zhang
- Hao Xu
- Xiao Liu
- Pan Li
- Wensheng Du
- Qiuyu Han
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Affiliations: Department of Obstetrics and Gynecology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, P.R. China, Department of Emergency, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, P.R. China
Published online on: July 2, 2019 https://doi.org/10.3892/etm.2019.7724
Pages: 1761-1767
Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present study aimed to evaluate changes of pregnancy‑associated plasma protein A (PAPP‑A) and vascular endothelial growth factor (VEGF) in pregnancy‑induced hypertension (PIH). A total of 105 cases (observation group) with complete data that underwent delivery and suffered from PIH in The Affiliated Hospital of Xuzhou Medical University from February 2015 to February 2017 were retrospectively analyzed. The observation group was further divided into the mild observation and severe observation groups according to severity degree of the disease. Another 65 asymptomatic pregnant women were recruited as the healthy control group. Basic data, obstetric data, PAPP‑A and VEGF and data of perinatal infants were compared and analyzed. The Logistic regression model was adopted to screen out risk factors for PIH. In the observation group, the rate of periodic antenatal care was lower, and there were more primigravidas and housewives, with lower education level and economic income (P<0.05). In the observation group, the occurrence rates of placental abruption as well as turbid and bloody amniotic fluid were higher than those in the healthy control group (P<0.05). The neonatal birth weight was lower in the observation group than that in the healthy control group, while the occurrence rates of neonatal department transfer, small for gestational age (SGA), neonatal asphyxia and survival rates of perinatal infants were higher (P<0.05). PAPP‑A levels at 34‑40 gestational weeks in the observation group were significantly higher than those in the healthy control group (P<0.05). VEGF levels were lower than those in the healthy control group (P<0.05). Multivariate analysis revealed that high PAPP‑A value [odds ratio (OR)=3.736] and identity of housewife (OR=2.514) were risk factors for PIH, while high VEGF value (OR=5.258), non‑primigravid (OR=2.173), higher economic income (OR=4.162) and periodic antenatal care (OR=1.201) were regarded as protective factors. Therefore, enhancement of gestational management, early discovery and early treatment are critical for improving the prognosis of pregnant women and infants.

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1	Perveen S: Frequency and impact of hypertensive disorders of pregnancy. J Ayub Med Coll Abbottabad. 26:518–521. 2014.PubMed/NCBI
2	Duley L: Maternal mortality associated with hypertensive disorders of pregnancy in Africa, Asia, Latin America and the Caribbean. Br J Obstet Gynaecol. 99:547–553. 1992. View Article : Google Scholar : PubMed/NCBI
3	Smith GC, Stenhouse EJ, Crossley JA, Aitken DA, Cameron AD and Connor JM: Early pregnancy levels of pregnancy-associated plasma protein A and the risk of intrauterine growth restriction, premature birth, preeclampsia, and stillbirth. J Clin Endocrinol Metab. 87:1762–1767. 2002. View Article : Google Scholar : PubMed/NCBI
4	Bersinger NA, Smárason AK, Muttukrishna S, Groome NP and Redman CW: Women with preeclampsia have increased serum levels of pregnancy-associated plasma protein A (PAPP-A), inhibin A, activin A and soluble E-selectin. Hypertens Pregnancy. 22:45–55. 2003. View Article : Google Scholar : PubMed/NCBI
5	Svedas E, Islam KB, Nisell H and Kublickiene KR: Vascular endothelial growth factor induced functional and morphologic signs of endothelial dysfunction in isolated arteries from normal pregnant women. Am J Obstet Gynecol. 188:168–176. 2003. View Article : Google Scholar : PubMed/NCBI
6	Luizon MR, Sandrim VC, Palei AC, Lacchini R, Cavalli RC, Duarte G and Tanus-Santos JE: Epistasis among eNOS, MMP-9 and VEGF maternal genotypes in hypertensive disorders of pregnancy. Hypertens Res. 35:917–921. 2012. View Article : Google Scholar : PubMed/NCBI
7	Razak A, Florendo-Chin A, Banfield L, Abdul Wahab MG, McDonald S, Shah PS and Mukerji A: Pregnancy-induced hypertension and neonatal outcomes: a systematic review and meta-analysis. J Perinatol. 38:46–53. 2018. View Article : Google Scholar : PubMed/NCBI
8	Ishimitsu T: Starting the new review series: Pregnancy-induced hypertension. Hypertension Research. 40:3–4. 2017. View Article : Google Scholar : PubMed/NCBI
9	Silahtaroglu AN, Tümer Z, Kristensen T, Sottrup-Jensen L and Tommerup N: Assignment of the human gene for pregnancy-associated plasma protein A (PAPPA) to 9q33.1 by fluorescence in situ hybridization to mitotic and meiotic chromosomes. Cytogenet Cell Genet. 62:214–216. 1993. View Article : Google Scholar : PubMed/NCBI
10	Lin TM, Galbert SP, Kiefer D, Spellacy WN and Gall S: Characterization of four human pregnancy-associated plasma proteins. Am J Obstet Gynecol. 118:223–236. 1974. View Article : Google Scholar : PubMed/NCBI
11	Folkersen J, Grudzinskas JG, Hindersson P, Teisner B and Westergaard JG: Pregnancy-associated plasma protein A: circulating levels during normal pregnancy. Am J Obstet Gynecol. 139:910–914. 1981. View Article : Google Scholar : PubMed/NCBI
12	Jussila L and Alitalo K: Vascular growth factors and lymphangiogenesis. Physiol Rev. 82:673–700. 2002. View Article : Google Scholar : PubMed/NCBI
13	Rak J, Yu JL, Klement G and Kerbel RS: Oncogenes and angiogenesis: Signaling three-dimensional tumor growth. J Investig Dermatol Symp Proc. 5:24–33. 2000. View Article : Google Scholar : PubMed/NCBI
14	Duyndam MC, Hilhorst MC, Schlüper HM, Verheul HM, van Diest PJ, Kraal G, Pinedo HM and Boven E: Vascular endothelial growth factor-165 overexpression stimulates angiogenesis and induces cyst formation and macrophage infiltration in human ovarian cancer xenografts. Am J Pathol. 160:537–548. 2002. View Article : Google Scholar : PubMed/NCBI
15	Kerbel RS: Tumor angiogenesis. N Engl J Med. 358:2039–2049. 2008. View Article : Google Scholar : PubMed/NCBI
16	Nanaev A, Frank HG, Chwalisz K and Kaufmann P: Physiological dilatation of uteroplacental arteries in the guinea pig is related to nos-activity of invasive trophoblast. Placenta. 16:A511995.
17	Rutherford RA, McCarthy A, Sullivan MH, Elder MG, Polak JM and Wharton J: Nitric oxide synthase in human placenta and umbilical cord from normal, intrauterine growth-retarded and pre-eclamptic pregnancies. Br J Pharmacol. 116:3099–3109. 1995. View Article : Google Scholar : PubMed/NCBI
18	Lam PM, Po LS, Cheung LP and Haines C: The effect of exogenous estradiol treatment on the mRNA expression of vascular endothelial growth factor and its receptors in cultured human oviduct mucosal cells. J Assist Reprod Genet. 22:251–255. 2005. View Article : Google Scholar : PubMed/NCBI
19	Tsatsaris V, Goffin F, Munaut C, Brichant JF, Pignon MR, Noel A, Schaaps JP, Cabrol D, Frankenne F and Foidart JM: Overexpression of the soluble vascular endothelial growth factor receptor in preeclamptic patients: pathophysiological consequences. J Clin Endocrinol Metab. 88:5555–5563. 2003. View Article : Google Scholar : PubMed/NCBI
20	Dekker GA: Risk factors for preeclampsia. Clin Obstet Gynecol. 42:422–435. 1999. View Article : Google Scholar : PubMed/NCBI
21	Abi-Said D, Annegers JF, Combs-Cantrell D, Frankowski RF and Willmore LJ: Case-control study of the risk factors for eclampsia. Am J Epidemiol. 142:437–441. 1995. View Article : Google Scholar : PubMed/NCBI
22	Schuiling GA and Faas MM: Etiology and pathogenesis of preeclampsia: current concepts. Am J Obstet Gynecol. 181:1036–1037. 1999. View Article : Google Scholar : PubMed/NCBI
23	Robillard PY, Dekker GA and Hulsey TC: Revisiting the epidemiological standard of preeclampsia: Primigravidity or primipaternity? Eur J Obstet Gynecol Reprod Biol. 84:37–41. 1999. View Article : Google Scholar : PubMed/NCBI
24	Hoff C, Peevy K, Giattina K, Spinnato JA and Peterson RD: Maternal-fetal HLA-DR relationships and pregnancy-induced hypertension. Obstet Gynecol. 80:1007–1012. 1992.PubMed/NCBI
25	Sletnes KE, Wisløff F, Moe N and Dale PO: Antiphospholipid antibodies in pre-eclamptic women: relation to growth retardation and neonatal outcome. Acta Obstet Gynecol Scand. 71:112–117. 1992. View Article : Google Scholar : PubMed/NCBI