Maternal Circulating Levels of Transforming Growth Factor-β Superfamily and Its Soluble Receptors in Hypertensive Disorders of Pregnancy

Objective: To assess circulating levels of transforming growth factor (TGF)-β superfamily members and their soluble receptors in hypertensive disorders of pregnancy, and to investigate associations with clinical manifestations.

Methods: A retrospective study was conducted using data for women admitted to a center in China for delivery between May 2011 and April 2013. Women with severe pre-eclampsia, mild pre-eclampsia, and gestational hypertension were included, along with a control group. Serum levels of activin A, inhibin A, TGF-β1, soluble endoglin (sEng), and soluble betaglycan (sBG) were measured.

Results: Women with severe pre-eclampsia (n = 17) had higher mean levels of activin A (23.5±2.1 μg/L), inhibin A (1.7±0.2 μg/L), sEng (32.1±3.2 μg/L), and sBG (84.1±9.4 μg/L) than did normotensive controls (n = 18), women with gestational hypertension (n = 15), and those with mild pre-eclampsia (n = 14; all P<0.05). Women with early-onset pre-eclampsia (n = 13) had higher levels of these serum markers than did preterm normotensive controls (n = 8; all P<0.001). Women with severe or early-onset pre-eclampsia had the lowest TGF-β1 levels. Activin A, inhibin A, sEng, and sBG levels were positively correlated with mean arterial pressure and proteinuria (all P<0.01).

Conclusion: Pre-eclampsia is associated with an imbalance of members of the TGF-β superfamily and their soluble receptors, which might contribute to the development of pre-eclampsia and help to predict onset and severity.