Abstract
Human placental lactogen (HPL) is a pregnancy-related hormone produced by the placenta. The overall functions of serum HPL impacts the developing fetus and placenta. The objective of this study was to determine the relationship between maternal serum concentration of HPL and sonographic fetal growth parameters in pregnancy induced hypertension as a marker of placental function. This prospective cross-sectional study was conducted over a 9-month period in the University of Calabar Teaching Hospital, Calabar, Nigeria that involved 100 women with pregnancy induced hypertension. An obstetric ultrasound scan was done on all the subjects and their blood was collected for HPL evaluation using Enzyme-linked Immunosorbent Assay (ELISA). SPSS version 20 was used to analyze the data. Maternal serum HPL had a significant positive correlation with PLA (P=0.000), estimated gestational age (P=0.000), estimated fetal weight (P=0.000) and amniotic fluid index AFI (P=0.000) and a significant negative correlation with proteinuria (P=0.047), fetal heart rate (P=0.032) and HC/AC (P=0.000). It is concluded that maternal serum HPL concentration increases as pregnancy advances and causes a significant increase in placental thickness, fetal weight and amniotic fluid volume, however, its reduction is significantly associated with the onset of pre-eclampsia, fetal distress and asymmetrical intra-uterine growth restriction. Thus, the evaluation of maternal serum HPL concentration is a reliable marker of placental function in the second half of pregnancy
References
Bersinger, N.A. and Ødegård, R.A. (2004). Second- and third-trimester serum levels of placental proteins in preeclampsia and small-for-gestational age pregnancies. Acta Obstet Gynecol Scand. 83(1), 37-45.
Burton, G.J., Fowden, A.L. and Thornburg, K.L. (2016). Placental Origins of Chronic Disease. Physiol Rev. 96(4):1509-1565. doi:10.1152/physrev.00029.2015
David, A.L. and Spencer, R.N. (2022). Clinical assessment of fetal well-being and fetal safety indicators. J Clin Pharmacol. 62 Suppl 1(Suppl 1), S67-S78. doi:10.1002/jcph.2126
Durkovic, J. and Mandic, B. (2009). The importance of determining human placental lactogen in the third trimester of pregnancy. JMB 28(2), 97-100.
Dutton, P.J., Warrander, L.K., Roberts, S.A., et al. (2012). Predictors of poor perinatal outcome following maternal perception of reduced fetal movements--a prospective cohort study. PLoS One. 7(7), e39784. doi:10.1371/journal.pone.0039784
Efanga, S.A. and Akintomide, A.O. (2020). Comparative sonographic evaluation of placental thickness in pregnancy-induced hypertension and normotensive pregnant women in the University of Calabar Teaching Hospital, Calabar. Calabar J Health Sci 4(1), 1-7.
Efanga, S.A, Akintomide, A.O., Okon, A.O., et al. (2023). Prevalence of abnormal umbilical arterial Doppler indices in apparently normal pregnancies in Calabar. Afr J Reprod Health 27(1), 63-72.
Garay, S.M., Sumption, L.A. and John, R.M. (2022). Prenatal health behaviours as predictors of human placental lactogen levels. Front Endocrinol (Lausanne). 13, 946539. doi:10.3389/fendo.2022.946539
Healy, D.L., Herington, A.C. and O'Herlihy, C. (1985). Chronic polyhydramnios is a syndrome with a lactogen receptor defect in the chorion laeve. Br J Obstet Gynaecol. 92(5), 461-467. doi:10.1111/j.1471-0528.1985.tb01349.x
Higgins, M.F., Russell, N.E., Crossey, P.A., et al. (2012). Maternal and fetal placental growth hormone and IGF axis in Type 1 diabetic pregnancy. PLoS ONE 7(2), e29164. doi:10.1371/journal.pone.0029164.
Higgins, L.E., Rey de Castro, N., Addo, N., et al. (2015). Placental Features of Late-Onset Adverse Pregnancy Outcome. PLoS One. 10(6), e0129117. doi:10.1371/journal.pone.0129117.
Jeckel, K.M., Boyarko, A.C., Bouma, G.J., Winger, Q.A and Anthony, R.V. (2018). Chorionic somatomammotropin impacts early fetal growth and placental gene expression. J Endocrinol. 237(3), 301-310. doi:10.1530/JOE-18-0093
Kastrup, K.W., Andersen, H.J. and Lebech, P. (1978). Somatomedin in newborns and the relationship to human chorionic somatotropin and fetal growth. Acta Paediatr Scand. 67(6), 757-762. doi:10.1111/j.1651-2227.1978.tb16257.x
Knopp, R.H., Bergelin, R.O., Wahl, P.W., et al. (1985). Relationships of infant birth size to maternal lipoproteins, apoproteins, fuels, hormones, clinical chemistries, and body weight at 36 weeks gestation. Diabetes 34 (Suppl. S2), 71–77.
Madaan, S., Mendiratta, S.L., Jain, P.K., et al. (2015). Amniotic fluid index and its correlation with fetal growth and perinatal outcome. J Fetal Med 2(2), 61-67. doi: 10.1007/s40556-015-0049-8.
Manokhina, I., Del Gobbo, G.F., Konwar, C., et al. (2017). Review: placental biomarkers for assessing fetal health. Hum Mol Genet. 26(R2), R237-R245. doi:10.1093/hmg/ddx210.
McIntyre, H.D., Serek, R., Crane, D.I., et al. (2000). Placental growth hormone (GH), GH-binding protein, and insulin-like growth factor axis in normal, growth-retarded, and diabetic pregnancies: correlations with fetal growth. J Clin Endocrinol Metab. 85(3), 1143-1150. doi:10.1210/jcem.85.3.6480.
Mittal, P., Espinoza, J., Hassan, S., et al. (2007). Placental growth hormone is increased in the maternal and fetal serum of patients with preeclampsia. J Matern Fetal Neonatal Med. 20(9), 651-659. doi:10.1080/14767050701463571
Pedersen, J.F., Sørensen, S. and Ruge, S. (1995). Human placental lactogen and pregnancy-associated plasma protein A in first trimester and subsequent fetal growth. Acta Obstet Gynecol Scand. 74(7), 505-508. doi:10.3109/00016349509024379
Peleg, D., Kennedy, C.M. and Hunter, S.K. (1998). Intrauterine growth restriction: identification and management. Am Fam Physician. 58(2), 453-467.
Rassie, K., Giri, R., Joham, A.E., et al. (2022). Human Placental Lactogen in Relation to Maternal Metabolic Health and Fetal Outcomes: A Systematic Review and Meta-Analysis. Int J Mol Sci. 23(24), 15621. doi:10.3390/ijms232415621
Reis, F.M., D'Antona, D. and Petraglia, F. (2002). Predictive value of hormone measurements in maternal and fetal complications of pregnancy. Endocr Rev. 23(2), 230-257. doi:10.1210/edrv.23.2.0459
Seppala, M. and Ruoslahti, E. (1970). Serum concentration of human placental lactogenic hormone (HPL) in pregnancy complications. Acta obstet, gynec, scand. 49, 143.
Sibiak, R., Jankowski, M., Gutaj, P., et al. (2020). Placental Lactogen as a Marker of Maternal Obesity, Diabetes, and Fetal Growth Abnormalities: Current Knowledge and Clinical Perspectives. J Clin Med. 9(4), 1142. doi:10.3390/jcm9041142
Sifakis, S., Akolekar, R., Mantas, N., et al. (2011). Maternal serum human placental growth hormone (hPGH) at 11 to 13 weeks of gestation in preeclampsia. Hypertens Pregnancy. 30(1), 74-82. doi:10.3109/10641955.2010.486461
Singer, W., Desjardins, P. and Friesen, H.G. (1970). Human placental lactogen: an index of placental function. Obstet, and Gynec, 36(2), 222-232.
Spellacy, W.N., Teoh, E.S., Buhi, W.C., et al. (1971). Value of human chorionic somatomammotropin in managing high-risk pregnancies. Am J Obstet Gynecol. 109(4), 588-598. doi:10.1016/0002-9378(71)90634-x
Spellacy, W.N., Buhi, W.C., Birk, S.A., et al. (1972). Human placental lactogen levels and intrapartum fetal distress: meconium-stained amniotic fluid, fetal heart rate patterns and Apgar scores. Amer, J. Obstet, Gynec, 114(6), 803-808.
Thomas, L. (2022). The role of the placenta in maternal mental health [Internet]. [updated 2022 Jan 27: cited 2023 Feb 19]. Available from: https://www.news-medical.net/health/The-Role-of-the-Placenta-in-Maternal-Mental-Health.aspx.
Velegrakis, A., Sfakiotaki, M. and Sifakis, S. (2017). Human placental growth hormone in normal and abnormal fetal growth. Biomed Rep. 7(2), 115-122. doi:10.3892/br.2017.930.
Voxman, E.G., Tran, S. and Wing. D.A. (2002). Low amniotic fluid index as a predictor of adverse perinatal outcome. J Perinatol. 22(4), 282-285. doi: 10.1038/sj.jp.7210697
Wilde, C.E. and Oakey, R.E. (1975). Scientific and Technical Committee; Association of Clinical Biochemists. Biochemical tests for the assessment of feto-placental function. Ann Clin Biochem. 12(3), 83-118. doi:10.1177/000456327501200124
Yu, X., Wu, H., Yang, Y., et al. (2022). Placental development and pregnancy-associated diseases. Maternal Fetal Med 4(1), 36–51. doi:10.1097/FM9.0000000000000134.

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