1. IS THERE AN ASSOCIATION OF SERUM PLACENTAL GROWTH FACTOR LEVELS IN PREGNANT WOMEN WITH GDM?
Ümit Görkem1, Cihan ToğruL1,
Emine Arslan1, Nafiye Yılmaz2,
Tayfun Güngör2
1-Hitit University Faculty of Medicine,
Obstetrics and Gynecology
2- ZTB Maternal Health Training and
Education Hospital

2. INTRODUCTION- OBJECTIVE
Placental growth factor (PlGF) secreted by the syncytiotrophoblast is found in the maternal circulation beginning in the sixth week of gestation.
Placental growth factor [PlGF] is a placenta- derived angiogenic protein involved in the regulation of placental vascular development [1].
1- Maynard SE, et al. J Clin Invest 2003;111: 649–58.

3. PlGF has been extensively investigated as a first trimester biomarker for pregnancy complications related to impaired placentation such as preeclampsia and birth weight deviations [2-4].
Also, inclusion of serum PlGF improves the performance of first-trimester screening test for trisomy 21 [5]. .
2- Levine RJ, et al. N Engl J Med 2004;350:672–83.
3- Akolekar R, et al.Ultrasound Obstet Gynecol 2008;32:732–9.
4- Poon LC, et al. Prenat Diagn 2008;28:1110–5.
5- Pandya P, et al. Fetal Diagn Ther 2012;31:87–93.

4. Previous studies by Ong and Syngelaki et al
Previous studies by Ong and Syngelaki et al. found increased serum PlGF levels in gestational diabetes (GDM) [6,7].
A recently published study also presented significantly higher first-trimester PlGF values in the GDM group [8] .
Another recent study did not find a relationship between PLGF measured at 11–14 weeks and subsequent GDM among 328 women recruited prospectively [9].
6- Syngelaki A, et al. Metabolism. 2015;64(11):1485– 9.
7- Ong CY, et al. J Reprod Med. 2004;49(6):477–80.
8- Eleftheriades M, et al. Metabolism 2014; 63: 1419–1425.
9- Mosimann B et al. . Fetal Diagn Ther. 2016;39:287–91.

5. At present, these findings remain contradictory.
However, newer data found that serum PlGF was decreased in women with diabetes mellitus type 1 and in those with type 2 disease [8].
At present, these findings remain contradictory.
Therefore, we aimed to investigate the associations of maternal serum placental growth factor (PlGF) levels with gestational diabetes mellitus (GDM).
8- Tsiakkas A, et al. Ultrasound Obstet Gynecol 2015; 45: 591–598.

6. MATERIAL-METHODS
This cross-sectional study was underwent in the Obstetrics and Gynecology Department of Hitit University between March, 2015 and September,
A total of 158 pregnant women were screened between 24 and 28 weeks of gestation.
All of the low risk pregnant women were evaluated with a 50-g glucose challenge test (GCT). Women with serum glucose ≥ 140 mg/dL at 1 h after GCT were subjected to a 100-g oral glucose tolerance test (OGTT).

7. Pregnant women who met the inclusion criteria were divided into two groups;
76 of the GDM group,
82 of the control group.
Maternal serum concentrations of PlGF, insulin and homeostasis model assessment- insulin resistance(HOMA-IR) were assessed.

10. Vasculogenesis and angiogenesis are essential for placental development and the VEGF family has been shown to play a key role [10].
A recent meta-analysis of studies investigating postpartum placental histology derived from pregnancies complicated by GDM demonstrates that there is increased placental volume, higher incidence of villous immaturity and increased angiogenesis [11].
10- Geva E, et al. J Clin Endocrinol Metab 2002; 87:4213–4224.
11- Huynh J, et al. Placenta 2015; 36: 101–114.

11. Particularly the fetoplacental vasculature and endothelium were shown to be susceptible to hyperglycemia [12].
Fetal hyperinsulinism as a result of maternal hyperglycemia stimulates placental angiogenesis [13].
Therefore, an increase in angiogenic markers such as PlGF might be a consequence of these alterations.
12- Cvitic S, et al. Biomed Res Int 2014; 2014:
13- Lassance L, et al. J Clin Endocrinol Metab 2013; 98:e1438–e1447.

12. CONCLUSION
We revealed that the serum PlGF levels were significantly increased in pregnants with GDM.
PlGF seems to have a role in pathogenesis and early GDM diagnosis.
Early identification of women at high risk for GDM could lead to an earlier diagnosis of the condition and improve the pregnancy outcomes.

13. Thank you for your attention