Association of increased cord blood soluble endoglin with the development of bronchopulmonary dysplasia in preterm infants with maternal preeclampsia

Abstract

Objectives: To investigate whether the levels of angiogenic factors in cord blood are associated with the development of bronchopulmonary dysplasia (BPD) in preterm infants with maternal preeclampsia. Study design: This retrospective cohort study included 199 singleton infants (gestational age < 32 weeks), including the preeclampsia group (59 infants) with severe/moderate BPD (24 infants) or no/mild BPD (35 infants) and the no preeclampsia group (140 infants). Main outcomes measures: The levels of soluble fms-like tyrosine kinase-1 (sFlt-1), soluble endoglin, and placental growth factor (PlGF) in cord blood were measured and compared among the study groups. Results: The soluble endoglin level and the ratio of (sFlt-1+ soluble endoglin) to PlGF were significantly higher in the preeclampsia group than in the no preeclampsia group (P < .05). Among preterm infants with maternal preeclampsia, both of these parameters were also significantly higher in the severe/moderate BPD group than the no/mild BPD group (P < .05). Receiver operator curve analysis revealed that increased cord blood soluble endoglin was predictive of severe or moderate BPD in preterm infants with maternal preeclampsia (area under the curve 0.73). Gestational age (adjusted odds ratio [OR] 0.25; P < .001) and high soluble endoglin level in cord blood (> 3420 pg/mL) (adjusted OR 11.9; P = .006) were significant risk factors for the development of severe or moderate BPD in the preeclampsia group according to multivariate logistic regression analysis. Conclusion: Increased cord blood soluble endoglin is associated with the development of severe or moderate BPD in preterm infants with maternal preeclampsia.