title: Preeclampsia is associated with low concentrations of protein Z.
abstract: OBJECTIVE
  Protein Z, a vitamin K-dependent plasma protein, has an important role in the regulation of the coagulation cascade. Protein Z deficiency has been associated with unexplained pregnancy loss and adverse pregnancy outcome in patients with thrombophilia. This study was conducted to determine if preeclampsia (PE), small for gestational age (SGA), and fetal demise are associated with changes in maternal plasma concentrations of protein Z.
  
  
  METHODS
  This cross-sectional study included normal pregnant women (N = 71), patients with PE (N = 130), patients who delivered an SGA neonate (N = 58), and patients with fetal demise (N = 58). Maternal plasma protein Z concentrations were measured by a sensitive and specific immunoassay. Protein Z deficiency was defined as maternal plasma concentrations <or=5th percentile of the normal pregnancy group (<or=1.59 microg/mL). Non-parametric statistics were used for analysis.
  
  
  RESULTS
  (1) Patients with PE had a lower median plasma concentration of protein Z than normal pregnant women (PE: median 1.6 microg/mL, range 0.2-3.3 microg/mL vs. normal pregnancy: median 2.4 microg/mL, range 1.1-3.4 microg/mL; p < 0.0001); (2) patients with an SGA neonate (median 2.3 microg/mL, range 0.2-3.8 microg/mL) and fetal demise (median 2.6 microg/mL, range 0.2-4.3 g/mL) did not have significantly different median protein Z concentrations from normal pregnant women (p > 0.05); and (3) women in the PE and fetal demise groups had significantly higher rates of protein Z deficiency than those with normal pregnancy outcome.
  
  
  CONCLUSIONS
  (1) PE, but not SGA or fetal demise, is associated with a significantly lower maternal median plasma concentration of protein Z than normal pregnancy, and (2) a high rate of protein Z deficiency is observed in patients with PE and fetal demise.
authors: Perinatology Research Branch, NICHD, NIH, DHHS Bethesda, Maryland, USA.
authors: Offer
authors: O
authors: Erez
authors: Debra
authors: D
authors: Hoppensteadt
authors: Roberto
authors: R
authors: Romero
authors: Jimmy
authors: J
authors: Espinoza
authors: Luis
authors: L
authors: Goncalves
authors: Jyh Kae
authors: JK
authors: Nien
authors: Juan Pedro
authors: JP
authors: Kusanovic
authors: Jawed
authors: J
authors: Fareed
authors: Francesca
authors: F
authors: Gotsch
authors: Beth
authors: B
authors: Pineles
authors: Tinnakorn
authors: T
authors: Chaiworapongsa
mesh_terms: D000328:Adult; D001798:Blood Proteins / Q000032:analysis*; D003430:Cross-Sectional Studies; D005260:Female; D005313:Fetal Death / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000502:physiology; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011256:Pregnancy Outcome
chemical_list: D001798:Blood Proteins; C026080:plasma protein Z
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