Pyelonephritis during pregnancy: a cause for an acquired deficiency of protein Z.
OBJECTIVE
Pyelonephritis has a more severe course during pregnancy than in the non-pregnant state. This has been attributed to the increased susceptibility of pregnant women to microbial products. An acquired protein Z deficiency has been reported when there is excessive thrombin activity. The aim of this study was to determine whether pyelonephritis during pregnancy is associated with changes in maternal plasma protein Z concentrations.


METHODS
A cross-sectional study was conducted to compare plasma protein Z concentrations between normal pregnant women (N = 71) and pregnant women with pyelonephritis (N = 42). Protein Z concentrations were measured by enzyme-linked immunosorbent assay. Parametric and non-parametric statistics were used for analysis.


RESULTS
Patients with pyelonephritis had a significantly lower median plasma concentration of protein Z than did patients with normal pregnancies (median 2.14 microg/mL (0.4-3.4) vs. median 2.36 microg/mL (1.09-3.36); p = 0.03). There was no difference in the median plasma concentration of anti-protein Z antibodies between patients with pyelonephritis and those with normal pregnancies.


CONCLUSIONS
The median maternal plasma protein Z concentration was significantly lower in patients with pyelonephritis during pregnancy than in patients with normal pregnancies.
Nien
Jyh Kae
JK
Perinatology Research Branch, NICHD, NIH, DHHS, Bethesda, Maryland, USA.
Romero
Roberto
R
Hoppensteadt
Debra
D
Erez
Offer
O
Espinoza
Jimmy
J
Soto
Eleazar
E
Kusanovic
Juan Pedro
JP
Gotsch
Francesca
F
Kim
Chong Jai
CJ
Mittal
Pooja
P
Fareed
Jawed
J
Santolaya
Joaquin
J
Chaiworapongsa
Tinnakorn
T
Edwin
Samuel
S
Pineles
Beth
B
Hassan
Sonia
S
D000293:Adolescent; D000328:Adult; D001798:Blood Proteins / Q000172:deficiency*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011704:Pyelonephritis / Q000097:blood*; D055815:Young Adult
D001798:Blood Proteins; C026080:plasma protein Z