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Human Chorionic Gonadotropin and Vascular Endothelial Growth Factor in Normal and Complicated Pregnancies

From the Department of Obstetrics and Gynecology, University Hospital of Puerto Real, Puerto Real, Cadiz, Spain.

Address reprint requests to: José L. Bartha, St. Michael’s Hospital, Fetal Medicine Research Unit, Division of Obstetrics and Gynaecology, Southwell Street, Bristol BS2 8EG, United Kingdom; E-mail: j.bartha{at}bristol.ac.uk.

OBJECTIVE: To study the relationships between maternal serum concentrations of ß-human chorionic gonadotropin (hCG) and vascular endothelial growth factor (VEGF) in both normal pregnant women during late pregnancy and women with pregnancy complications.

METHODS: Sixty-six women in three groups were prospectively studied: 1) women diagnosed with fetal growth restriction (n = 22), 2) women with preeclampsia (n = 22), and 3) healthy pregnant women (controls) frequency matched for age, parity, and gestational age (n = 22). Primary outcomes were maternal serum concentrations of both ß-hCG and VEGF. Placental insufficiency was defined by a pulsatility index in umbilical artery greater than the 99th percentile for gestation.

RESULTS: Maternal serum concentrations of ß-hCG and VEGF were greater in women with preeclampsia than in controls (P = .001 and P = .002, respectively) and women with fetal growth restriction (P = .002 and P = .002, respectively). Concentrations did not differ between women with fetal growth restricted fetuses and controls. Correlation between ß-hCG and VEGF was not significant in any of the studied groups. Serum VEGF concentrations were significantly increased in a subgroup of 12 women with placental insufficiency (P = .04) and correlated with ß-hCG concentrations (r = .63, P = .02).

CONCLUSION: Both VEGF and ß-hCG maternal serum concentrations were increased in women with preeclampsia but normal in women with fetal growth restriction, although VEGF concentrations were increased in those cases with placental insufficiency. Maternal serum ß-hCG and VEGF concentrations did not correlate except in women with placental insufficiency.