Publication Date
3-1-2023
Journal
Pregnancy Hypertension
DOI
10.1016/j.preghy.2022.11.008
PMID
36525933
PMCID
PMC9719935
PubMedCentral® Posted Date
12-5-2022
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
Pregnancy, Female, Humans, Pre-Eclampsia, Prospective Studies, Placenta, Vascular Endothelial Growth Factor Receptor-1, COVID-19, SARS-CoV-2, Placenta Growth Factor, Biomarkers, Receptor Protein-Tyrosine Kinases, Vascular Endothelial Growth Factor A, Maternal health, COVID-19, Hypertensive disorders of pregnancy, Renin-angiotensin system
Abstract
OBJECTIVES: To analyze soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factors (PlGF) concentrations and their ratio in pregnant and postpartum women with suspected COVID-19, and further investigate conditions associated with an increased ratio (sFlt-1/PlGF > 38), including preeclampsia (PE) and severe acute respiratory syndrome (SARS).
STUDY DESIGN: The present study is a secondary analysis of a prospective cohort. Blood samples were collected at time of COVID-19 investigation and the serum measurements of sFlt-1 and PlGF were performed. Clinical background, SARS-CoV-2 infection characteristics, maternal and perinatal outcomes were further analyzed.
MAIN OUTCOME MEASURES: Serum measurements of sFlt-1 and PlGF; obstetrics and clinical outcomes.
RESULTS: A total of 97 SARS-CoV-2 unvaccinated women with suspected infection were considered, 76 were COVID-19 positive cases and 21 COVID-19 negative. Among COVID-19 positive cases, 09 presented with SARS and 11 were diagnosed with PE, of which 6 had SARS-CoV-2 infection in first and second trimester (04 with sFlt-1/PlGF ≥ 38) and 05 with PE and COVID-19 diagnosed at the same time, during third trimester (03 with sFlt-1/PlGF ≥ 38). Five presented with PE with severe features. sFlt-1/PlGF ratio was significantly higher in the COVID-19 positive/PE positive group compared to COVID-19 positive/PE negative group (p-value = 0.005), with no increase in cases complicated by SARS.
CONCLUSIONS: sFlt-1/PlGF ratio could be a useful tool for differential diagnosis and adequate counseling among cases of COVID-19 and PE, especially if severe disease. COVID-19 early in pregnancy could potentially be a risk factor for PE later during gestation.
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Allergy and Immunology Commons, Clinical Epidemiology Commons, Community Health and Preventive Medicine Commons, COVID-19 Commons, Immune System Diseases Commons, Maternal and Child Health Commons, Medical Immunology Commons, Obstetrics and Gynecology Commons, Women's Health Commons
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