Angiogenic biomarkers are polypeptide molecules produced in the trophoblast and endothelial cells of the placenta which regulate important pregnancy-related processes such as implantation, remodeling of spiral arteries, development of tertiary villi, and optimum exchange of nutrients and oxygen between the fetus and the mother. When measured in the early trimester, it helps in predicting adverse pregnancy outcomes and in the third trimester it helps in tailoring antenatal monitoring in women with a myriad of pregnancy-related problems. With more than one women having pregnancies at an older age and with the use of artificial reproductive technology, most pregnancies will have high-risk factors. Angiogenic markers open up a lot of opportunities for obstetricians to be more alert and identify red flag signs and reduce iatrogenic prematurity and perinatal morbidity and mortality.
Patan S. Vasculogenesis and angiogenesis. Cancer Treat Res 2004;117:3–32. DOI: 10.1007/978-1-4419-8871-3_1.
Demir R, Seval Y, Huppertz B. Vasculogenesis and angiogenesis in the early human placenta. Acta Histochem 2007;109(4):257–265. DOI: 10.1016/j.acthis.2007.02.008.
Gaccioli F, Aye ILMH, Sovio U, et al. Screening for fetal growth restriction using fetal biometry combined with maternal biomarkers. Am J Obstet Gynecol 2018;218(2S):S725–S737. DOI: 10.1016/j.ajog.2017.12.002.
Hund M, Allegranza D, Schoedl M, et al. Multicenter prospective clinical study to evaluate the prediction of short-term outcome in pregnant women with suspected preeclampsia (PROGNOSIS): study protocol. BMC Pregnancy Childbirth 2014;14(1):324. DOI: 10.1186/1471-2393-14-324.
Gaccioli F, Sovio U, Cook E, et al. Screening for fetal growth restriction using ultrasound and the sFLT1/PlGF ratio in nulliparous women: a prospective cohort study. Lancet Child Adolesc Health 2018;2(8):569–581. DOI: 10.1016/S2352-4642(18)30129-9.
Smith GC, Crossley JA, Aitken DA, et al. Circulating angiogenic factors in early pregnancy and the risk of preeclampsia, intrauterine growth restriction, spontaneous preterm birth, and stillbirth. Obstet Gynecol 2007;109(6):1316–1324. DOI: 10.1097/01.AOG.0000265804.09161.0d.
Stepan H, Unversucht A, Wessel N, et al. Predictive value of maternal angiogenic factors in second trimester pregnancies with abnormal uterine perfusion. Hypertension 2007;49(4):818–824. DOI: 10.1161/01.HYP.0000258404.21552.a3.
Kim M, Bunyon J, Guerra M, et al. Angiogenic factor imbalance in early pregnancy predicts adverse outcomes in patients with lupus and antiphospholipid antibodies: results of PROMISSE study. Am J Obstet Gynecol 2016;214(1):108.e1–108.e14. DOI: 10.1016/j.ajog.2015.09.066.
Nuzzo AM, Giuffrida D, Moretti L, et al. Placental and maternal sFlt1/PlGF expression in gestational diabetes mellitus. Sci Rep 2021;11(1):2312. DOI: 10.1038/s41598-021-81785-5.
Loegl J, Nussbaumer E, Cvitic S, et al. GDM alters paracrine regulation of feto-placental angiogenesis via the trophoblast. Lab Invest 2017;97(4):409–418. DOI: 10.1038/labinvest.2016.149.
Lee M, Cantonwine D, Little S, et al. Angiogenic markers in pregnancies conceived through in vitro fertilisation. Am J Obstet Gynaecol 2015;213(2):212e.1-e.18. DOI: 10.1016/j.ajog.2015.03.032.