Association Between Maternal Angiogenic Markers in Hypertensive Disorders of Pregnancy and Neonatal Growth and Body...

Background/Objectives: Hypertensive disorders of pregnancy (HDPs) such as preeclampsia are associated with adverse maternal and perinatal outcomes and related to high soluble fms-like tyrosine kinase-1 (sFlt-1) levels and low placental growth factor (PlGF) levels. While these biomarkers are used for predicting and diagnosing preeclampsia, their impact on postnatal neonatal nutritional management, growth, and body composition is not well-established. Therefore, we aimed to evaluate the association between maternal angiogenic markers, neonatal growth, and body composition. Methods: This study represents a secondary analysis of a prospective cohort study conducted at the Medical University of Vienna. Women with HDP were included in the analysis, and infants were stratified by gestational age at birth into preterm (<37 weeks of gestation) and term (≥37 weeks of gestation) groups. Maternal angiogenic markers were routinely measured at the time when HDP was first suspected, and neonatal body composition was assessed at term-equivalent age. Results: A total of 335 infants were screened, 94 of which (preterm: n = 72; term: n = 22) were included. Higher sFlt-1/PlGF ratios were significantly correlated with lower fat-free mass (FFM) z-scores (rs = -0.408; p = 0.004), but not with fat mass (FM) z-scores (p = 0.21), weight (p = 0.19), length (p = 0.31), or head circumference z-scores (p = 0.32) in preterm infants. In a linear regression model adjusted for potential neonatal confounders, higher sFlt-1/PlGF ratios were independently and significantly associated with lower FFM in preterm infants (median: -0.10, 95% CI: -0.2, 0.00; p = 0.036). In term infants, sFlt-1/PLGF ratios were not significantly correlated with FFM (p = 0.86), FM z-scores (p = 0.41), weight (p = 0.10), length (p = 0.12), or head circumference z-scores (p = 0.2). Conclusions: These findings suggest that the sFlt-1/PLGF ratio is not only a well-established marker of HDP severity during pregnancy but may also be associated with adverse effects on body composition in preterm infants, particularly in fat-free mass (FFM).