Electronic Letters to:

Endocrine Care: Katja-Anneli Wathén, Eija Tuutti, Ulf-Håkan Stenman, Henrik Alfthan, Erja Halmesmäki, Patrik Finne, Olavi Ylikorkala, and Piia Vuorela Maternal Serum-Soluble Vascular Endothelial Growth Factor Receptor-1 in Early Pregnancy Ending in Preeclampsia or Intrauterine Growth Retardation J Clin Endocrinol Metab 2006; 91: 180-184 [Abstract] [Full text] [PDF]

eLetters: Submit a response to this article

Electronic letters published:

Soluble vascular endothelial growth factor receptor-1 in intrauterine growth retardation

Holger Stepan, Renaldo Faber   (21 February 2006)

Soluble vascular endothelial growth factor receptor-1 in intrauterine growth retardation 21 February 2006
Holger Stepan, Obstetrician University of Leipzig, Renaldo Faber Send letter to journal: Re: Soluble vascular endothelial growth factor receptor-1 in intrauterine growth retardation holger.stepan{at}medizin.uni-leipzig.de Holger Stepan, et al.	We read with interest the paper by Wathen et al. (1) in which the authors report unchanged sFlt1 levels in pregnancies with intrauterine growth retardation (IUGR) in comparison to normal pregnancies. Others, including our group, have reported elevated maternal sFlt1 concentrations (2, 3). This relation is of interest because it provides insight into the relationship between preeclampsia, in which sFlt1 levels are incontrovertibly elevated, and IUGR. We believe that different definitions of IUGR are responsible for these conflicting findings. In the paper by Wathen et al. (1), IUGR is defined as a birth weight below a certain percentile (two SD values below the national average at the particular gestational age). This definition is often mixed with the term small for gestational-age (SGA) and includes not only fetuses with IUGR due to placental insufficiency, but also fetuses with a lower genetic growth potential, but which are otherwise healthy without malnutrition or hypoxia. The classification below a percentile, although adjusted for gestational age and gender, covers a rather heterogeneous group of fetuses with widely different reasons for their low birth weight. A study that investigates a possible alteration of the angiogenic-antiangiogenic balance should consider pregnancies with “real” IUGR. Consequently, we suggest using an additional criterion like Doppler sonography of the uterine arteries or placental histomorphology in order to characterize these pregnancies more accurately. References 1. Wathen KA, Tuutti E, Stenman UH, Alfthan H, Halmesmaki E, Finne P, Ylikorkala O, Vuorela P. 2006. Maternal serum-soluble vascular endothelial growth factor receptor-1 in early pregnancy ending in preeclampsia or intrauterine growth retardation. J Clin Endocrinol Metab 91:180-184 2. Stepan H, Geide A, Faber R. 2004. Soluble fms-like tyrosine kinase 1. N Engl J Med 351:2241-2242 3. Tsatsaris V, Goffin F, Munaut C, Brichant JF, Pignon MR, Noel A, Schaaps JP, Cabrol D, Frankenne F, Foidart JM. 2003. Overexpression of the soluble vascular endothelial growth factor receptor in preeclamptic patients: pathophysiological consequences. J Clin Endocrinol Metab 88:5555-5563