The effects of maternal anticoagulant therapy on cord blood levels of VEGF-A and soluble Flt-1 in women with recurrent miscarriage

Angiogenic imbalance of the placenta is one of the prominent pathophysiologic mechanisms leading to pregnancy complications like recurrent miscarriage. Low molecular weight heparin and low dose aspirin are frequently used in the management of recurrent miscarriages. Vascular endothelial growth factor (VEGF) and its soluble receptor-sFlt-1-plays a major role in angiogenesis. This study aims to investigate cord blood VEGF-A and sFlt-1 levels of women with recurrent miscarriages who receive anticoagulant treatment. Term newborns whose mothers were treated with LMWH and low-dose aspirin due to recurrent miscarriage were prospectively included. A control group consisted of healthy gestational age-matched infants who were born in the same period without an adverse perinatal outcome. The concentrations of VEGF-A and sFlt 1 in umbilical cord blood were assayed by ELISA and compared between the study and control groups. Forty-four infants with a maternal LMWH and low dose aspirin treatment during pregnancy and 42 healthy infants as a control group were included in the study. There were no significant differences in demographics, cord blood VEGF-A and sFlt-1 levels between the groups. There was also no correlation between the cumulative LMWH dosage and serum levels of these angiogenic factors.Cord blood VEGF-A and sFlt-1 levels were comparable in women with recurrent miscarriage under anticoagulant treatment and healthy subjects. Further studies are needed to compare women who have recurrent miscarriage with or without heparin treatment to better understand the effects of anticoagulant treatment on circulatory profile of cord blood angiogenic factors.