Objective: To study the impact of intrauterine growth restriction (IUGR) on anti-angiogenesis, by determining and comparing circulating levels of the potent anti-angiogenic factor endostatin, in full-term IUGR (under the 10th customized centile) and appropriate for gestational age (AGA) fetuses, neonates, as well as their mothers, granted that IUGR implies hypoxia and endostatin is down-regulated by the latter.
Methods: In 20 IUGR cases (mainly due to hypertension or preeclampsia) and 20 AGA controls we determined circulating endostatin levels, by enzyme immunoassay in the serum of mothers (MS), umbilical cords (UC-mixed arteriovenous blood)-representing the fetal state, and asymptomatic neonates on day 1 (N1) and 4 (N4) of life-signifying transition and stabilization to extrauterine life, respectively.
Results: Endostatin levels were significantly higher in AGA than IUGR UC, N1, and N4 (P <.0000, P = .0006, P = .024, respectively). Furthermore, UC endostatin levels positively correlated with the customized centiles of the infants (Spearman correlation coefficient 0.69, P = .00001).
Conclusions: IUGR is characterized by lower circulating endostatin concentrations in the fetus and neonate, possibly because under lower oxygen concentrations an unbalanced state of angiogenesis stimulators versus inhibitors takes place.