Abstract
Disclosure: C. Amadi: None. B.C. Amadi: None. J.C. Okafor: None. E. Agbo: None. Background: Stress and distortions of placenta-derived angiogenic parameters are known to be associated with pre-eclampsia. However, the relationship between stress and these angiogenic biochemical parameters in pre-eclampsia is yet to be evaluated, hence, the conduct of this study. Subjects and methods: This longitudinal study was conducted among 510 healthy pregnant patients recruited in their first trimester (≤13 weeks gestation) while presenting for antenatal clinic visits in several health centers in Rivers State, Southern Nigeria. Hair cortisol status (HaCS), placenta-derived pro-angiogenic factors [serum vascular endothelial growth factor A (VEGF-A)/placental growth factor (PLGF)], and the placenta-derived anti-angiogenic factors [serum soluble fms-like tyrosine kinase-1 (sFlt-1)/soluble endoglin (sEng)] were measured in serum at baseline (≤13 weeks gestation), at the end of second trimester (26 weeks gestation), and at debut of pre-eclampsia in the third trimester (27-40 weeks). The laboratory analyses of biochemical parameters were done using the enzyme-linked immunosorbent assay method. Statistical product for service solutions version 25.0 for Windows was used for statistical analyses at an alpha value of <0.05. Result: By the end of the follow-up, 56 (10.9%) developed pre-eclampsia. Most pre-eclamptic patients (n=53; 94.6%) had HaCS values within the range designated to be stress-associated (>128 pg/mg hair) at baseline, at the end of the second trimester, and at the onset of pre-eclampsia. The pre-eclamptic patients with high stress-associated HaCS had higher mean serum levels of anti-angiogenic factors (sFlt-1/sEng) but lower mean serum levels of the pro-angiogenic factors (VEGF-A/PLGF)) at baseline, at the end of the second trimester, and at the debut of pre-eclampsia compared to those (n=454) who did not develop pre-eclampsia (p<0.05, respectively). An increasing trend of HaCS, in parallel with increasing serum anti-angiogenic factors but a decreasing trend of serum pro-angiogenic factors, was observed from baseline to onset of pre-eclampsia among the pre-eclamptic patients (p<0.05). HaCS correlated positively with sFlt-1(r=0.578; p<0.001) and sEng (r=0.609; p<0.001) but negatively with EGF-A (-0.540; p<0.001) and PLGF (-0.611; p<0.001) at the debut of pre-eclampsia. Conclusion: These findings suggest an association between stress-associated cortisol and placenta-derived angiogenic biochemical factors. However, further studies are encouraged to verify these conclusions. Presentation: Monday, July 14, 2025