The Association of Fetal and Maternal Thrombospondin-1 (TSP-1) and Vascular Endothelial Growth Factor (VEGF) Serum Levels with Selected Fetal and Maternal Characteristics.

BACKGROUND

Thrombospondin-1 (TSP-1) and vascular endothelial growth factor (VEGF) are placental glycoproteins involved in angiogenesis and vascular regulation during pregnancy. Dysregulation of these markers has been linked to complications such as preeclampsia and intrauterine growth restriction. In this cross-sectional study, we evaluated maternal and fetal serum levels of TSP-1 and VEGF and their associations with clinical characteristics.

METHODS

We studied 438 pregnant women with singleton live pregnancies between 28-40 weeks of gestation. Women with fetal anomalies were excluded. Serum levels of TSP-1 and VEGF were measured using enzyme immunoassay. Group comparisons were performed using the Mann-Whitney U and Kruskal-Wallis tests, and correlations were analyzed using Spearman's test.

RESULTS

Median maternal and fetal TSP-1 levels were 5.1 [2.6-7.4] ng/mL and 4.7 [2.3-8.9] ng/mL, respectively. Fetal TSP-1 levels positively correlated with maternal TSP-1 (r = 0.27, p < 0.000) and fetal VEGF (r = 0.21, p < 0.000). Lower fetal TSP-1 was observed in women with diabetes mellitus (1.9 vs 4.7 ng/mL, p = 0.042) and higher levels in those with small-for-gestational-age fetuses (8.5 vs 4.7 ng/mL, p = 0.036). Median maternal and fetal VEGF levels were 37.2 [33.3-42.5] pg/mL and 148 [62.9-247.8] pg/mL. A positive correlation was found between maternal and fetal VEGF (r = 0.24, p < 0.000). Lower maternal VEGF was associated with chronic hypertension, gestational diabetes, preterm premature rupture of membranes, and use of methyldopa or metformin. Fetal VEGF was higher in mothers taking thyroxine (220 vs 142.7 pg/mL, p = 0.018) and lower during established labor (114.1 vs 165.5 pg/mL, p = 0.038).

CONCLUSION

Maternal and fetal levels of TSP-1 and VEGF were significantly correlated and influenced by clinical and pharmacologic factors, supporting their potential utility as early biomarkers of pregnancy complications and maternal-fetal health.

REGISTRATION: Research Registry (UIN: researchregistry6781), April 30, 2021.