title: Fetal corticotrophin-releasing hormone mRNA, but not phosphatidylserine-exposing microparticles, in maternal plasma are associated with factor VII activity in pre-eclampsia.
abstract: BACKGROUND
  Pre-eclampsia is associated with increased placental debris circulating in maternal plasma.
  
  
  OBJECTIVE
  This study related placental debris to maternal markers of coagulation and endothelial activation in pre-eclampsia.
  
  
  METHODS
  Circulating fetal corticotrophin-releasing hormone (CRH) mRNA and phosphatidylserine (PS)-exposing microparticles were assayed in third trimester plasma from women with pre-eclampsia (n = 32) and controls (n = 32) matched for age, body mass index, parity, and gestational age at sampling. Markers of maternal hemostasis and endothelial function were assessed.
  
  
  RESULTS
  Fetal CRH mRNA levels were higher in pre-eclampsia [mean 0.75 (SD 2.77) CRH/glyceraldehyde-3-phosphate dehydrogenase (GAPDH) mRNA ratio] than in control pregnancies [0.20 (0.74), P = 0.014]. PS-exposing microparticle levels were not different between the groups. Women with pre-eclampsia had higher levels of tissue factor pathway inhibitor (TFPI), prothrombin F(1+2) fragment (F(1+2)), factor XIIa, soluble vascular cell adhesion molecule 1, von Willebrand factor and plasminogen activator inhibitor 1 than controls. Fetal CRH mRNA correlated with TFPI in pre-eclampsia and control groups (r = 0.38, P = 0.031, and r = 0.37, P = 0.039, respectively). Fetal CRH mRNA correlated with FVII activity (r = 0.43, P = 0.017) and PS-exposing microparticles correlated inversely with F(1+2) (r = -0.64, P < 0.001) in pre-eclampsia.
  
  
  CONCLUSIONS
  Placental debris, assessed by fetal CRH mRNA levels in maternal blood, is related to coagulation potential, i.e. FVII activity, but not to markers of coagulation or endothelial activation in pre-eclampsia.
authors.affiliation: Reproductive and Maternal Medicine, Division of Developmental Medicine, University of Glasgow, Royal Infirmary, Glasgow, UK. d.freeman@clinmed.gla.ac.uk
authors.forename: D J
authors.initials: DJ
authors.lastname: Freeman
authors.forename: K
authors.initials: K
authors.lastname: Tham
authors.forename: E A
authors.initials: EA
authors.lastname: Brown
authors.forename: A
authors.initials: A
authors.lastname: Rumley
authors.forename: G D
authors.initials: GD
authors.lastname: Lowe
authors.forename: I A
authors.initials: IA
authors.lastname: Greer
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003346:Corticotropin-Releasing Hormone / Q000378:metabolism*; D005167:Factor VII / Q000737:chemistry*; D005260:Female; D006487:Hemostasis; D006801:Humans; D008954:Models, Biological; D010718:Phosphatidylserines / Q000737:chemistry*; D011225:Pre-Eclampsia / Q000097:blood* / Q000378:metabolism*; D011247:Pregnancy; D012333:RNA, Messenger / Q000378:metabolism*
chemical_list: D010718:Phosphatidylserines; D012333:RNA, Messenger; D005167:Factor VII; D003346:Corticotropin-Releasing Hormone