Low levels of plasma protein S, protein C and coagulation factor XII during early pregnancy and adverse pregnancy outcome.

Publisher: Thieme Country of Publication: Germany NLM ID: 7608063 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2567-689X (Electronic) Linking ISSN: 03406245 NLM ISO Abbreviation: Thromb Haemost Subsets: MEDLINE

Publication: 2018- : Stuttgart : Thieme
Original Publication: Stuttgart, Schattauer.

Blood Coagulation*; Blood Proteins/*analysis ; Factor XII/*analysis ; Factor XII Deficiency/*blood ; Pregnancy Complications, Hematologic/*blood ; Protein C/*analysis ; Protein C Deficiency/*blood ; Protein S Deficiency/*blood; Adolescent ; Adult ; Biomarkers/blood ; Factor XII Deficiency/diagnosis ; Factor XII Deficiency/etiology ; Female ; Gestational Age ; Humans ; Hypertension, Pregnancy-Induced/blood ; Hypertension, Pregnancy-Induced/etiology ; Logistic Models ; Multivariate Analysis ; Odds Ratio ; Pregnancy ; Pregnancy Complications, Hematologic/diagnosis ; Pregnancy Complications, Hematologic/etiology ; Premature Birth/blood ; Premature Birth/etiology ; Prospective Studies ; Protein C Deficiency/diagnosis ; Protein C Deficiency/etiology ; Protein S ; Protein S Deficiency/diagnosis ; Protein S Deficiency/etiology ; Risk Assessment ; Risk Factors ; Young Adult

It was the study objective to evaluate whether low levels of plasma protein S (PS) activity, free PS, protein C (PC) activity and coagulation factor XII (FXII) during early pregnancy are related to adverse pregnancy outcomes. Peripheral blood samples were obtained at 8-14 gestational weeks (GW) from a consecutive series of 1,220 women. The levels of plasma PS activity, free PS, PC activity, and FXII were measured. Cut-off values were defined as < 1st, < 5th, and < 10th percentiles of values obtained from 933 women whose pregnancies ended in normal deliveries without complications. PS activity of < 10th percentile yielded risks of pregnancy-induced hypertension (PIH) and severe PIH, while free PS level of < 5th percentile yielded a risk of pre-eclampsia. FXII level of < 1st percentile yielded a risk of premature delivery (PD) at < 34 GW. None was associated with PD at < 37 GW, fetal growth restriction or fetal loss. A multivariate analysis demonstrated that PS activity of < 10th percentile (odds ratio 5.9, 95 % confidence interval 1.7-18.1) and body mass index (BMI) ≥ 25 kg/m² (4.3, 1.1-13.3) were independent risk factors for severe PIH. Similarly, free PS level of < 5th percentile (4.4, 1.0-14.3) and BMI ≥ 25 kg/m² (4.0, 1.3-10.9) were independent risk factors for pre-eclampsia. In conclusion, women with low levels of plasma PS activity and free PS during early pregnancy might have increased risks of PIH, severe PIH or pre-eclampsia. Women with low FXII level might have an increased risk of PD at < 34 GW.

Keywords: Factor XII; pregnancy; pregnancy-induced hypertension; premature delivery; protein C; protein S

0 (Biomarkers)
0 (Blood Proteins)
0 (PROS1 protein, human)
0 (Protein C)
0 (Protein S)
9001-30-3 (Factor XII)

Date Created: 20150417 Date Completed: 20160407 Latest Revision: 20220318

20231215

10.1160/TH14-11-0928

25879167