Elevated plasma levels of factor VIII in women with early recurrent miscarriage.
OBJECTIVE
Inherited and acquired thrombophilia have been found to be associated with recurrent pregnancy loss. This paper examines whether or not elevated factor (F)VIII:C plasma levels, which have been demonstrated to be an independent risk factor for venous thromboembolism, are a risk factor for early recurrent miscarriages also.


METHODS
Consecutive women referred to our clinic with a history of early recurrent abortion (at least three pregnancy losses before week 13 of gestation) were eligible for the study. Exclusion criteria were endocrine, immunological, anatomical and genetic causes of embryo demise, as well as any thrombophilic abnormality, either congenital or acquired, or a personal or familial history of venous thromboembolism. FVIII:C plasma levels were determined in 51 cases and in 51 controls matched for age, ethnicity and blood group.


RESULTS
The mean FVIII:C level in the control subjects was 106.8 IU dL-1, compared with 128.2 IU dL-1 in the patients group (P = 0.0002). Thirteen (25.5%) of the 51 patients had FVIII:C values exceeding the 90th centile of the control population (145 IU dL-1), compared with four subjects in the control group (chi2 = 4.52; P = 0.033; odds ratio = 4.02, 95% confidence interval 1.09, 16.05). No cases with increase in FVIII:C levels attributable to an acute-phase reaction, as assessed by C-reactive protein plasma concentration, were found.


CONCLUSIONS
We found FVIII:C levels significantly higher in women with early recurrent miscarriage compared with controls. This finding suggests a possible association between this thrombophilic condition and early reproductive failures.
Marietta
M
M
Department of Oncology and Hematology, Section of Hematology, University of Modena and Reggio Emilia, Modena, Italy. marietta@unimo.it
Facchinetti
F
F
Sgarbi
L
L
Simoni
L
L
Bertesi
M
M
Torelli
G
G
Volpe
A
A
D000026:Abortion, Habitual / Q000097:blood* / Q000209:etiology; D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D005169:Factor VIII / Q000032:analysis*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011486:Protein C / Q000032:analysis; D012307:Risk Factors; D019851:Thrombophilia / Q000150:complications
D011486:Protein C; D005169:Factor VIII; D002097:C-Reactive Protein