Expression of vascular endothelial growth factor in third-trimester placentas is not increased in growth-restricted fetuses

OBJECTIVE: Vascular endothelial growth factor (VEGF) is considered the grow th factor that stimulates vasculogenesis and angiogenesis. Recent studies h ave demonstrated its role in regulating placental growth and invasion. Its expression can be upregulated by hypoxia. Intrauterine growth restriction ( IUGR) is thought to be associated with inadequate placental perfusion, whic h might result from a failure in the development of the villous vascular ne twork. Our present study was undertaken to examine the relationship between VEGF expression and IUGR in pregnancies with preserved umbilical artery en d-diastolic flow. METHODS: VEGF Expression was determined by immunohistochemical analysis of placentas from 17 pregnancies with normal infant birth weight and 17 pregna ncies complicated by IUGR. Results: We found no significant differences in the expression of VEGF in v illous syncytiotrophoblasts and intermediate trophoblasts in maternal decid ua between IUGR and normal pregnancies. However, in both groups there was a strong correlation in the expression of VEGF with villous syncytiotrophobl asts and intermediate trophoblasts. In normal and IUGR pregnancies the infa nts' Apgar scares at birth were significantly correlated with VEGF staining in both syncytiotrophoblasts and intermediate trophoblasts (P < .05). A st rong correlation also was found between cord hematocrit and VEGF staining i n villous syncytiotrophoblasts (P < .05), but VEGF staining in intermediate trophoblasts was not correlated with cord hemoglobin or hematocrit. CONCLUSIONS: Our results suggest that VEGF acts in an autocrine and paracri ne fashion in both normal and IUGR placentas, and its expression can have a n effect on the well being of the infant at birth. Copyright (C) 2001 by th e Society for Gynecologic Investigation.