Cord blood biomarkers of vascular endothelial growth (VEGF and sFlt-1) and postnatal growth: A preterm birth cohort study

Stephannie Baehl Voller*, Susanne Chock, Linda M. Ernst, Emily Su, Xin Liu, Kathryn N. Farrow, Karen K. Mestan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Background: Preterm infants are at risk for postnatal growth failure (PGF). Identification of biomarkers that are associated with neonatal growth may help reduce PGF and associated long-term morbidity. Objective: To investigate the associations between cord blood vascular endothelial growth factor (VEGF) and its soluble receptor (sFlt-1) with birth weight (BW) and postnatal growth in premature infants. Study design and methods: From an ongoing birth cohort, 123 premature infants from 23 to 36 weeks gestational age (GA) were studied. Cord blood plasma VEGF and sFlt-1 were measured via enzyme-linked immunoassay. Growth parameters and nutritional information were evaluated. Multivariate logistic regression models were constructed to evaluate the associations of VEGF and sFlt-1 on PGF, defined as weight <. 10th percentile at 36. weeks corrected age or discharge. Results: VEGF was positively correlated, and sFlt-1 was negatively correlated with BW and BW-for-GA percentiles. Higher cord blood VEGF levels were associated with reduced risk of PGF (OR. =. 0.7; 95% CI. =. 0.5-0.9), while higher sFlt-1 levels appeared to increase the risk of PGF (OR. =. 1.6; 95% CI. =. 1.1-2.4). The above biomarker associations were attenuated after adjustment for maternal preeclampsia, fetal growth restriction and related neonatal characteristics, and when taking into account placental vascular pathologies. Longitudinal growth patterns by mean weight and length percentiles were consistently lower among infants with low VEGF/sFlt-1 ratios. Conclusions: Our data support that intrauterine regulation of angiogenesis is an important mechanism of fetal and postnatal growth. Cord blood VEGF and sFlt-1 are useful in elucidating how intrauterine processes may have long-standing effects on developing premature infants.

Original languageEnglish (US)
Pages (from-to)195-200
Number of pages6
JournalEarly Human Development
Issue number4
StatePublished - Apr 2014


  • Birth weight
  • Cord blood
  • Fetal growth restriction
  • Fetal origins
  • Postnatal growth
  • Preterm infants
  • Vascular endothelial growth factor (VEGF)

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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