title: High frequency of protein Z deficiency in patients with unexplained early fetal loss.
abstract: The protein Z-protein Z-dependent inhibitor complex is a factor Xa inhibitor. Protein Z deficiencies have recently been described in patients with ischemic stroke. As placenta infarction leads to poor pregnancy outcome, we studied protein Z plasma concentrations in nonthrombotic, nonthrombophilic consecutive patients with unexplained pregnancy wastage. A significant amount of protein Z deficiencies was only found in the early fetal loss group (< 1 mg/L; 44 of 200, P < 10(-4)) and mainly in the case of fetal demise between the beginning of the 10th and the end of the 15th week of gestation (odds ratio, 6.7 [3.1-14.8], P < 10(-3)). These deficiencies were not due to partial vitamin K1 deficiency, and at least some of them were constitutional ones. In women, protein Z deficiency may induce an enhanced risk of severe placental insufficiency soon after the connection of maternal and fetal circulations.
authors.affiliation: Laboratoires d'Hématologie, U.F.R. des sciences pharmaceutiques et biologiques de Montpellier, Centres Hospitaliers Universitaires de Nîmes et de Rouen, 5 rue Hoche, F-30 029 Nimes cedex 9, France. jcgris@chu-nimes.fr
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Gris
authors.forename: Isabelle
authors.initials: I
authors.lastname: Quéré
authors.forename: Hervé
authors.initials: H
authors.lastname: Dechaud
authors.forename: Eric
authors.initials: E
authors.lastname: Mercier
authors.forename: Caroline
authors.initials: C
authors.lastname: Pinçon
authors.forename: Médéric
authors.initials: M
authors.lastname: Hoffet
authors.forename: Marc
authors.initials: M
authors.lastname: Vasse
authors.forename: Pierre
authors.initials: P
authors.lastname: Marès
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology*; D000328:Adult; D001798:Blood Proteins / Q000172:deficiency / Q000378:metabolism*; D005260:Female; D006801:Humans; D011247:Pregnancy
chemical_list: D001798:Blood Proteins; C026080:plasma protein Z