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Background Levels of anti-angiogenic proteins (soluble fms-like tyrosine kinase [sFlt1] and soluble endoglin [sEng]) are elevated during pregnancy in women with hypertensive disorders of pregnancy (HDP). The objective was to assess whether women with HDP have an angiogenic factor imbalance in the postpartum period that may predispose them to a future cardiovascular disease. Methods This is a secondary analysis of a prospective study of singleton pregnancies in which anti-angiogenic proteins and cardiovascular function was assessed throughout pregnancy and up to one year postpartum. sFlt1 (pg/ml) and sEng (ng/ml) were measured by ELISA. Women with preeclampsia, were labeled as proteinuric hypertension and gestational/chronic hypertension were labeled as non-proteinuric hypertension. Comparison of baseline characteristics and anti-angiogenic factors was assessed with a parametric or non-parametric t -test, as appropriate. Results Of 86 patients with both antepartum and postpartum levels of angiogenic factors, 25 were normal, 26 had non-proteinuric hypertension and 35 had proteinuric hypertension. Antepartum levels of anti-angiogenic proteins were significantly elevated in proteinuric hypertension (median sFlt1 15955.9, IQR: 8207.1–20076.4; sEng 32.0, IQR: 15.4–56.9) in comparison to non-proteinuric hypertension (sFlt1 5567.7, IQR: 3340.4–7077.9; sEng 13.5, IQR: 8.1–20.2) and normal patients (sFlt1 1915.76, IQR: 1263.65–4357.84; sEng 8.21, IQR: 5.44–11.46; all p p = 0.87) or sEng (means 4.69, 4.41, and 4.05 for normal, non-proteinuric and proteinuric hypertension, respectively; p = 0.20). There was no significant difference in postpartum levels at 3, 6 or 12 months. Conclusion Postpartum circulating plasma levels of anti-angiogenic factors were not different among women who were hypertensive during pregnancy compared to normal women. Interactions of angiogenic proteins with other factors or local abnormality in angiogenesis in specific organs such as the heart may be contributing to increased long-term cardiovascular morbidity among these women. |
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