Published online August 1, 2005
PEDIATRICS Vol. 116 No. 2 August 2005, pp. 468-472 (doi:10.1542/peds.2004-2240)
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Excess Soluble fms-Like Tyrosine Kinase 1 and Low Platelet Counts in Premature Neonates of Preeclamptic Mothers

Po-Nien Tsao, MD, PhD*,{ddagger}, Shu-Chen Wei, MD, PhD§, Yi-Ning Su, MD, PhD{ddagger}, Hung-Chieh Chou, MD*, Chien-Yi Chen, MD* and Wu-Shiun Hsieh, MD*

* Pediatrics
{ddagger} Department of Medical Genetics
§ Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan

Objective. To investigate the relationship of neonatal platelet count and preeclampsia to levels of soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF), and vascular endothelial growth factor (VEGF) in the cord blood of preterm infants.

Methods. Sixty-nine preterm infants with a gestational age between 26 and 37 weeks at birth were enrolled. sFlt-1, PlGF, and VEGF levels in the cord blood of preterm neonates, with or without maternal preeclampsia, were measured using a standardized sandwich enzyme-linked immunosorbent assay method.

Results. Infants with maternal preeclampsia had higher cord blood sFlt-1 but lower PlGF and VEGF levels. There was a significantly positive relationship between neonatal platelet count and birth weight and a significantly negative relationship between neonatal platelet count and cord blood sFlt-1 levels. Multiple regression analysis revealed that only birth weight and cord blood sFlt-1 levels were independently related to neonatal platelet count, whereas maternal preeclampsia, gestational age (GA), and small for GA (SGA) were not related. Neonates with thrombocytopenia had higher cord blood sFlt-1 levels but lower birth weight. A significant correlation was also found between birth weight and cord blood sFlt-1 levels. Multiple regression with birth weight as the dependent variable found that only GA and cord blood sFlt-1 levels were independently related. Furthermore, infants with high cord blood sFlt-1 were more likely to have lower platelet count and maternal preeclampsia, be SGA, and have a trend toward lower birth weight.

Conclusion. Excess sFlt-1 may play an important role in the development of maternal preeclampsia- induced neonatal thrombocytopenia, and SGA.

Key Words: sFlt-1 • vascular endothelial growth factor • placenta growth factor • preeclampsia • platelets

Abbreviations: SGA, small for gestational age • VEGF, vascular endothelial growth factor • PlGF, placenta growth factor • sFlt-1, soluble fms-like tyrosine kinase 1 • GA, gestational age • VLBW, very low birth weight • Tpo, thrombopoietin • Mk, megakaryocytic

Accepted Dec 2, 2004.




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