ASSOCIATION OF MATERNAL ANGIOGENIC MARKERS WITH ADVERSE NEONATAL OUTCOMES IN PREGNANCIES WITH ESTIMATED FETAL WEIGHT BELOW THE 10TH PERCENTILE

Abstract

Objective: To evaluate the association between maternal angiogenic markers and neonatal outcomes in pregnancies with an estimated fetal weight (EFW) below the 10th percentile. Methods: This prospective study included 95 singleton pregnancies with EFW below the 10th percentile. Maternal serum placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured, and the sFlt-1/PlGF ratio was calculated. Neonatal outcomes included birth weight, respiratory distress syndrome (RDS), neonatal sepsis, intraventricular hemorrhage (IVH), neonatal death, and duration of neonatal intensive care unit (NICU) hospitalization. Associations were assessed using Spearman’s rank correlation. Results: PlGF was positively correlated with birth weight (ρ = 0.5654, p < 0.001), whereas sFlt-1 (ρ = −0.4644, p < 0.001) and the sFlt-1/PlGF ratio (ρ = −0.5693, p < 0.001) were negatively correlated with birth weight. RDS, neonatal sepsis, and IVH were significantly associated with lower PlGF and higher sFlt-1 concentrations and sFlt-1/PlGF ratios. Lower PlGF levels were weakly associated with neonatal mortality (ρ = −0.2159, p = 0.036), while sFlt-1 and the sFlt-1/PlGF ratio were not. No significant correlations were observed with NICU hospitalization duration. Conclusions: Maternal angiogenic imbalance was associated with lower birth weight and increased neonatal morbidity in pregnancies with fetal growth below the 10th percentile. Angiogenic biomarkers may complement conventional fetal assessment in identifying pregnancies at increased risk of adverse neonatal outcomes.