Soluble vascular endothelial growth factor receptor-1 in intrauterine growth restricted fetuses and neonates

Background: Angiogenesis, a critical process for growth and development is altered in intrauterine growth restriction (IUGR). Vascular endothelial growth factor (VEGF) and its receptors VEGFR-1, soluble (s) VEGFR-1 and VEGFR-2 represent a regulatory system, essential for both physiological and pathological angiogenesis. Aim: To study the implication of sVEGFR-1-a VEGF antagonist-in IUGR. Study design: Prospective study. Methods: Twenty-five IUGR and 15 appropriate for gestational age (AGA) full-term fetuses and neonates with their mothers were included in the study. Outcome measures: sVEGFR-1 levels were determined by enzyme immunoassay in the serum of: mothers (MS), umbilical cords (UC)-representing fetal state-and neonates on day 1 (N1) and 4 (N4) of life. Results: MS, UC, N1 and N4 sVEGFR-1 levels in IUGR were significantly higher compared to respective AGA cases (p=0.005, p=0.026, p=0.005 and p=0.017, respectively). In IUGR and AGA groups, maternal sVEGFR-1 levels were significantly higher than fetal and neonatal levels (p in all cases < 0.001). The tatter presented in both IUGR and AGA groups a significant decrease from UC to N4 (p in all cases < 0.01). MS, NI and N4 sVEGFR-1 levels negatively correlated with the infants' customized centiles [(r=-0.489, p=0.001), (r=-0.440, p=0.004), (r=-0.431, p=0.006), respectively]. Conclusions: Higher sVEGFR-1 levels in the IUGR as compared to the AGA group possibly reflect the predominance of antiangiogenic mechanisms present in IUGR. The decrease of sVEGFR-1 levels from UC to N4 may represent ex utero initiation of growth and development and therefore, prevalence of angiogenic mechanisms. (c) 2005 Elsevier Ireland Ltd. All. rights reserved.