Levels of soluble Syndecan-1 and VEGF-A in maternal and cord blood in the presence of placental lesions of maternal vascular underperfusion and its association with fetal aortic intima media thickness.

INTRODUCTION

Placenta is an essential organ for a healthy pregnancy, thus maternal vascular hypoperfusion has been associated with adverse outcomes. Syndecan-1 and VEGF-A are involved in the placentation process. However, whether these proteins could serve as early markers of placental damage or fetal vascular damage is still unknown.

METHODS

A clinical study was carried out in 66 healthy pregnant women in the second trimester of pregnancy, with follow-up until delivery. The maternal age, height, and weight were collected. Ultrasound examination was performed to obtain fetal growth measures and fetal abdominal aorta characteristics. At birth, a histopathological study of the placenta was performed, and the newborn's weight and height were recorded. Maternal serum Syndecan-1 and VEGF-A levels were measured by ELISA in the second trimester and in cord blood serum at delivery. Analysis was performed with Student's t-test, and correlation tests.

RESULTS

Placental histopathological analysis revealed a prevalence of 76% multiple infarcts, 64% increased syncytial knots, 27% distal villous hypoplasia, and 12% acute atherosis. Maternal Syndecan-1 levels were significantly lower in the presence of placental multiple infarcts (p < 0.001), acute atherosis (p = 0.018), distal villous hypoplasia (p < 0.001), and increased syncytial knots (p < 0.001). Maternal VEGF-A levels were not different in the presence of placental lesions. Maternal and umbilical cord blood Syndecan-1 levels correlated with fetal abdominal aorta Intima-media thickness (r = -0.57, p < 0.001, and r = 0.74, p < 0.001, respectively). Umbilical cord blood VEGF-A also correlated with fetal abdominal aorta Intima-media thickness (r = 0.43, p < 0.001).

CONCLUSION

Maternal and cord blood Syndecan-1 could be an early marker of placental damage and fetal aortic intima media thickness.