Maternal Serum Angiopoietin And Vascular Endothelial Growth Factor (Vegf) Levels In Preeclampsia And Pregnancy Outcomes

Abstract

Introduction: Preeclampsia remains a major obstetric complication globally, accompanied by a significant burden of adverse maternal and perinatal outcomes especially among Sub-Saharan African (SSA) countries including Ghana. The high maternal and perinatal outcomes of preeclampsia may be due to the lack of consensus on the ideal clinical and therapeutic intervention which stems from the insufficient knowledge on the actual etiology and pathophysiological mechanisms that underline the disease progression. Aim: To explore maternal serum levels of angiopoietins (1 and 2), Vascular endothelial growth factor (VEGF), and pregnancy outcomes in preeclampsia. Methods: The study was a comparative cross-sectional study with cases and controls, conducted at the Obstetrics and Gynaecology Department of the Korle-Bu Teaching Hospital (KBTH). A systematic random sampling technique was used to recruit study participants consisting of women diagnosed with preeclampsia (cases), pregnant normotensives (control group 1), and non-pregnant normotensives (control group 2). A structured data extraction form was used to collect data on the demographic and clinical features of the study participants. Results: A total of 263 women including 75 non-pregnant normotensives, 94 pregnant normotensives, and 94 with established diagnosis of preeclampsia (PE) were enrolled. The study revealed that maternal serum VEGF [4.71 (IQR: 3.65, 7.93) pg/ml], Ang-2 levels [1.25 (IQR: 0.90, 2.15) ng/ml] and VEGF/Ang-2 ratio [3.85 (IQR: 1.91, 11.38)] in the PE group were significantly lower than in the normotensives controls. Although elevated maternal serum Ang-1 levels were found, the difference between women with PE and normotensive controls did not reach statistical significance (p>0.05). VEGF levels were significantly lower in early-onset PE [(3.89 (2.87, 4.78)pg/ml;p=0.014] than in late-onset PE [5.23 (3.78, 16.97) pg/ml] while Ang-1/VEGF ratio was found to be higher in early-onset PE [20.62(15.76,