Objective: In women with preeclampsia (PE), the serum concentration of the growth factor angiopoietin-2 (Ang-2) is significantly lower than in unaffected controls. The objective of this study is to determine if the decrease in serum Ang-2 is evident from the first trimester of pregnancy before the clinical onset of PE.
Methods: Serum Ang-2 and uterine artery pulsatility index (PI) were measured at 11 to 13 weeks in 126 pregnancies that subsequently developed PE, 88 cases that developed gestational hypertension (GH) and 214 unaffected controls.
Results: Maternal serum Ang-2 in the PE group [0.96 multiple of the median (MoM)] and in GH (1.12 MoM) was not significantly different from the unaffected group (1.07 MoM). Uterine artery PI was significantly higher in the PE group (1.32 MoM) but not in GH (1.11 MoM) compared to the unaffected group (1.05 MoM).
Conclusion: In pregnancies that develop PE there is Doppler evidence of impaired placentation from the first trimester of pregnancy. However, the impaired placentation is not reflected in altered maternal serum levels of Ang-2.