The Effects of Maternal Anticoagulant Therapy on Cord Blood Levels of VEGF-A and Soluble Flt-1 in Women with Recurrent Miscarriage

Abstract

Angiogenic imbalance of the placenta is one of the prominent pathophysiologic mechanisms leading to pregnancy complications like recurrent miscarriages. Low molecular weight heparin and low dose aspirin are frequently used to manage recurrent miscarriages. Vascular endothelial growth factor (VEGF) and its soluble receptor-sFlt-1-plays a major role in angiogenesis. This study investigates cord blood VEGF-A and sFlt-1 levels of women with recurrent miscarriages who receive anticoagulant treatment. We included term newborns whose mothers were treated with LMWH and low-dose aspirin due to recurrent miscarriages. The control group consisted of healthy gestational age-matched infants born in the same period without an adverse perinatal outcome. We assayed the concentrations of VEGF-A and sFlt 1 in umbilical cord blood by ELISA and compared the study and control groups. We included in the study forty-four infants with a maternal LMWH and low dose aspirin treatment during pregnancy and 42 healthy infants as the control group. There were no significant differences between the groups' demographics and cord blood VEGF-A and sFlt-1 levels. There was also no correlation between the cumulative LMWH dosage and serum levels of these angiogenic factors. Cord blood VEGF-A and sFlt-1 levels were comparable in women with recurrent miscarriage under anticoagulant treatment and healthy subjects. Further studies are needed to compare women with recurrent miscarriages with or without heparin treatment to understand better the effects of anticoagulant treatment on the circulatory profile of cord blood angiogenic factors. © 2022 Ondokuz Mayis Universitesi. All rights reserved.