{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:44:36Z","timestamp":1791380676337,"version":"4.3.3"},"reference-count":28,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:00:00Z","timestamp":1624924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Preeclampsia occurs more often in dichorionic than in monochorionic twin pregnancy. We hypothesize that serum concentrations of biomarkers: placental growth factor (PlGF), serum soluble fms-like tyrosine kinase-1 (sFlt-1), and endoglin (Eng) differ between monochorionic and dichorionic twin pregnancies. Methods: A prospective observational study including 43 monochorionic and 36 dichorionic twin gestation was conducted. Blood samples were collected twice from all participants: between 11 + 0 and 13 + 6 and between 32 + 0 and 34 + 0 weeks of gestation. PlGF, sFlt-1 and Eng were measured using immnunoenzymatic assays. Results: We found a significantly higher concentration of sFlt-1 in dichorionic in comparison to monochorionic pregnancies in both the first and third trimesters. PlGF and sEng levels did not differ between mono- and dichorionic gestation in both study periods. sFlt-1 level was related to twin gestation chorionicity, while PlGF expression was not. PlGF, sFlt-1 and sEng concentrations increased significantly during gestation and were much higher in the third trimester compared to the values measured in the first trimester. Conclusions: Angiogenic biomarkers expression differ between dichorionic and monochorionic twin pregnancy. The sFlt-1 level is related to chorionicity of a twin gestation.<\/jats:p>","DOI":"10.3390\/diagnostics11071181","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T10:52:46Z","timestamp":1624963966000},"page":"1181","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["sFlt-1, Not PlGF, Is Related to Twin Gestation Choronicity in the First and Third Trimesters of Pregnancy"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5492-0676","authenticated-orcid":false,"given":"Szymon","family":"Koz\u0142owski","sequence":"first","affiliation":[{"name":"University Center for Woman and Newborn Health of the Medical University of Warsaw, Starynkiewicza Square 1\/3, 02-015 Warsaw, Poland"},{"name":"Department of Obstetrics and Gynecology, Institute of Mother and Child, Kasprzaka 17a, 01-211 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3667-1220","authenticated-orcid":false,"given":"Anna","family":"Stelmaszczyk-Emmel","sequence":"additional","affiliation":[{"name":"Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, \u017bwirki i Wigury 63A, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iwona","family":"Szymusik","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicza Square 1\/3, 02-015 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Saletra-Bieli\u0144ska","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicza Square 1\/3, 02-015 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Brawura-Biskupski-Samaha","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicza Square 1\/3, 02-015 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawe\u0142","family":"Pietruski","sequence":"additional","affiliation":[{"name":"Independent Public Complex of Healthcare Institutions in Pu\u0142tusk, 3 Maja 5, 06-100 Pu\u0142tusk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Osi\u0144ska","sequence":"additional","affiliation":[{"name":"2nd Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Ceg\u0142owska 80, 01-809 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5461-273X","authenticated-orcid":false,"given":"Katarzyna","family":"Kosi\u0144ska-Kaczy\u0144ska","sequence":"additional","affiliation":[{"name":"2nd Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Ceg\u0142owska 80, 01-809 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e323","DOI":"10.1016\/S2214-109X(14)70227-X","article-title":"Global causes of maternal death: A WHO systematic analysis","volume":"2","author":"Say","year":"2014","journal-title":"Lancet Glob. Health"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Fox, R., Kitt, J., Leeson, P., Aye, C.Y.L., and Lewandowski, A.J. (2019). Preeclampsia: Risk Factors, Diagnosis, Management, and the Cardiovascular Impact on the Offspring. J. Clin. Med., 8.","DOI":"10.3390\/jcm8101625"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S9","DOI":"10.1016\/j.ajog.2015.08.003","article-title":"Preeclampsia, biomarkers, syncytiotrophoblast stress, and placental capacity","volume":"213","author":"Redman","year":"2015","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Yagel, S., Cohen, S.M., and Goldman-Wohl, D. (2021). An integrated model of preeclampsia: A multifaceted syndrome of the maternal cardiovascular-placental-fetal array. Am. J. Obstet. Gynecol.","DOI":"10.1016\/j.ajog.2020.10.023"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1038\/s41581-019-0119-6","article-title":"Pre-eclampsia: Pathogenesis, novel diagnostics and therapies","volume":"15","author":"Phipps","year":"2019","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.preghy.2018.04.010","article-title":"Predictive value of sFlt-1, PlGF, sFlt-1\/PlGF ratio and PAPP-A for late-onset preeclampsia and IUGR between 32 and 37 weeks of pregnancy","volume":"12","author":"Birdir","year":"2018","journal-title":"Pregnancy Hypertens."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1038\/nm1429","article-title":"Soluble endoglin contributes to the pathogenesis of preeclampsia","volume":"12","author":"Venkatesha","year":"2006","journal-title":"Nat. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1056\/NEJMoa1414838","article-title":"Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia","volume":"374","author":"Zeisler","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1093\/humrep\/der394","article-title":"First trimester serum angiogenic\/anti-angiogenic status in twin pregnancies: Relationship with assisted reproduction technology","volume":"27","author":"Llurba","year":"2012","journal-title":"Hum. Reprod."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1002\/uog.14873","article-title":"First- and second-trimester maternal serum markers of pre-eclampsia in twin pregnancy","volume":"47","author":"Svirsky","year":"2016","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11906-020-01107-4","article-title":"Multiple Gestations and Hypertensive Disorders of Pregnancy: What Do We Know?","volume":"23","author":"Narang","year":"2020","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Kosinska-Kaczynska, K., Zgliczynska, M., Kozlowski, S., and Wicherek, L. (2020). Maternal Serum Placental Growth Factor, Soluble Fms-Like Tyrosine Kinase-1, and Soluble Endoglin in Twin Gestations and the Risk of Preeclampsia\u2014A Systematic Review. J. Clin. Med., 9.","DOI":"10.3390\/jcm9010183"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e029908","DOI":"10.1136\/bmjopen-2019-029908","article-title":"Prevalence and risk of pre-eclampsia and gestational hypertension in twin pregnancies: A population-based register study","volume":"9","author":"Laine","year":"2019","journal-title":"BMJ Open"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1017\/thg.2016.17","article-title":"Twin Chorionicity and the Risk of Hypertensive Disorders: Gestational Hypertension and Pre-eclampsia","volume":"19","author":"Bartnik","year":"2016","journal-title":"Twin Res. Hum. Genet."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.3109\/14767058.2013.847414","article-title":"Risk of preeclampsia: Comparison between dichorionic and monochorionic twin pregnancies","volume":"27","author":"Sarno","year":"2014","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.3109\/14767058.2013.777701","article-title":"Does risk of preeclampsia differ by twin chorionicity?","volume":"26","author":"Sparks","year":"2013","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1002\/uog.17531","article-title":"Competing-risks model in screening for pre-eclampsia in twin pregnancy according to maternal factors and biomarkers at 11\u201313 weeks\u2019 gestation","volume":"50","author":"Francisco","year":"2017","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_18","unstructured":"(2019). ACOG Practice Bulletin No. 202: Gestational Hypertension and Preeclampsia. Obstet. Gynecol., 133, 1."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"341","DOI":"10.5603\/GP.a2018.0059","article-title":"Standards of Polish Society of Gynecologists and Obstetricians in management of women with diabetes","volume":"89","author":"Celewicz","year":"2018","journal-title":"Ginekol. Pol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"200.e1-7","DOI":"10.1016\/j.ajog.2007.08.042","article-title":"Circulating angiogenic factors in singleton vs multiple-gestation pregnancies","volume":"198","author":"Maynard","year":"2008","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"870","DOI":"10.3109\/14767058.2013.845156","article-title":"Angiogenic growth factors in maternal and fetal serum in concordant and discordant twin pregnancies","volume":"27","author":"Borras","year":"2014","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Faupel-Badger, J.M., McElrath, T.F., Lauria, M., Houghton, L.C., Lim, K.H., Parry, S., Cantonwine, D., Lai, G., Karumanchi, S.A., and Hoover, R.N. (2015). Maternal circulating angiogenic factors in twin and singleton pregnancies. Am. J. Obstet. Gynecol., 212.","DOI":"10.1016\/j.ajog.2014.11.035"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1002\/pd.4243","article-title":"First trimester maternal serum placental growth factor levels in twin pregnancies","volume":"33","author":"Cowans","year":"2013","journal-title":"Prenat. Diagn."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"428.e1","DOI":"10.1016\/j.ajog.2007.10.783","article-title":"Twin pregnancy and the risk of preeclampsia: Bigger placenta or relative ischemia?","volume":"198","author":"Bdolah","year":"2008","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1210\/jc.2005-1076","article-title":"Maternal serum-soluble vascular endothelial growth factor receptor-1 in early pregnancy ending in preeclampsia or intrauterine growth retardation","volume":"91","author":"Tuutti","year":"2006","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"4838","DOI":"10.1210\/en.2004-0533","article-title":"Cytotrophoblasts up-regulate soluble fms-like tyrosine kinase-1 expression under reduced oxygen: An implication for the placental vascular development and the pathophysiology of preeclampsia","volume":"145","author":"Nagamatsu","year":"2004","journal-title":"Endocrinology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.preghy.2018.03.014","article-title":"The predictive value of the sFlt-1\/PlGF ratio on short-term absence of preeclampsia and maternal and fetal or neonatal complications in twin pregnancies","volume":"14","author":"Saleh","year":"2018","journal-title":"Pregnancy Hypertens."},{"key":"ref_28","first-page":"607","article-title":"Risks for preeclampsia and small for gestational age: Predictive values of placental growth factor, soluble fms-like tyrosine kinase-1, and inhibin A in singleton and multiple-gestation pregnancies","volume":"30","author":"Boucoiran","year":"2013","journal-title":"Am. J. Perinatol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/7\/1181\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:26:54Z","timestamp":1760164014000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/7\/1181"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,29]]},"references-count":28,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7]]}},"alternative-id":["diagnostics11071181"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics11071181","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,29]]}}}