Circulating Soluble Endoglin Levels in Pregnant Women in Cameroon and Malawi—Associations with Placental Malaria and Fetal Growth Restriction
Open accessAbstract
Placental infections with Plasmodium falciparum are associated with fetal growth restriction resulting in low birth weight (LBW). The mechanisms that mediate these effects have yet to be completely described; however, they are likely to involve inflammatory processes and dysregulation of angiogenesis. Soluble endoglin (sEng), a soluble receptor of transforming growth factor (TGF)-β previously associated with preeclampsia in pregnant women and with severe malaria in children, regulates the immune system and influences angiogenesis. We hypothesized that sEng may play a role in development of LBW associated with placental malaria (PM). Plasma levels of sEng were measured in women (i) followed prospectively throughout pregnancy in Cameroon (n = 52), and (ii) in a case-control study at delivery in Malawi (n = 479). The relationships between sEng levels and gravidity, peripheral and placental parasitemia, gestational age, and adverse outcomes of PM including maternal anemia and LBW were determined. In the longitudinal cohort from Cameroon, 28 of 52 women (54%) experienced at least one malaria infection during pregnancy. In Malawi we enrolled two aparasitemic gravidity-matched controls for every case with PM. sEng levels varied over the course of gestation and were significantly higher in early and late gestation as compared to delivery (P<0.006 and P<0.0001, respectively). Circulating sEng levels were higher in primigravidae than multigravidae from both Cameroon and Malawi, irrespective of malarial infection status (p<0.046 and p<0.001, respectively). Peripheral parasitemia in Cameroonian women and PM in Malawian women were each associated with elevated sEng levels following correction for gestational age and gravidity (p = 0.006 and p = 0.033, respectively). Increased sEng was also associated with the delivery of LBW infants in primigravid Malawian women (p = 0.017); the association was with fetal growth restriction (p = 0.003) but not pre-term delivery (p = 0.286). Increased circulating maternal sEng levels are associated with P. falciparum infection in pregnancy and with fetal growth restriction in primigravidae with PM.
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Soluble endoglin increases during PM and, like sFlt1, is a marker of preeclampsia.
“and soluble endoglin, which increases during PM and, like sFlt1, is a marker of preeclampsia [83].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [83]
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References 59 · Cited by 43
- Authors
- Silver, K. L., Conroy, A. L., Leke, R. G. F., Leke, R. J. I., Gwanmesia, P., Molyneux, M. E., Wallace, D. T., Rogerson, S. J., & Kain, K. C.
- Affiliations
- University Health Network (CA)
- Université de Yaoundé I (CM)
- University of Liverpool (GB)
- University of Hawaiʻi at Mānoa (US)
- The Royal Melbourne Hospital (AU)
- Corresponding author
- Kain, Kevin C.
- ORCID
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2011-09-22
- Volume
- 6
- Issue
- 9
- Pages
- e24985
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3178568
- OpenAlex
- W2074249282
- Cited by
- 43
- References
- 59
- Citations by year
- 2026: 2 · 2023: 1 · 2022: 1 · 2021: 8 · 2020: 2 · 2019: 3 · 2018: 5 · 2017: 2 · 2016: 3 · 2015: 6 · 2014: 3 · 2013: 4 · 2012: 3
- FWCI
- 3.10
- Type
- journal article
- Language
- en
- Update notices
- correction (2011-10-07)
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Greater South Information System
- Funders
- Wellcome Trust (063215/Z/00/Z)
- Mitacs
- National Institutes of Health (063215)
- Canadian Institutes of Health Research (MOP- 13721, 115160, 13721, 115160_1)
- National Institute of Allergy and Infectious Diseases (R01AI071160, 5UO1AI43888, U01AI043888)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Keywords
- soluble endoglin, placental malaria, Plasmodium falciparum, fetal growth restriction, low birth weight, pregnancy, primigravida, gravidity, anemia in pregnancy, angiogenesis, TGF-beta, Cameroon, Malawi
- MeSH terms
- Endoglin, Adolescent, Adult, Cameroon, Female, Fetal Growth Retardation, Gestational Age, Humans, Malaria, Malawi, Placenta, Pregnancy, Pregnancy Outcome, Prospective Studies, Receptors, Cell Surface, Pregnancy Complications, Parasitic, Antigens, CD, Case-Control Studies, Transforming Growth Factor beta, Neovascularization, Physiologic
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