First trimester maternal concentrations of thrombin-inhibitor complexes and the presence of histologic placental lesions at delivery.
OBJECTIVE
Placental fetal vessel thrombosis or vasculitis and retroplacental hematoma have been associated with adverse neonatal outcomes. The activation of thrombin may contribute to the development of thrombosis and inflammation, and can be assessed through the measurement of thrombin-inhibitor complexes.


METHODS
A nested case-control study was performed within a cohort of women with singleton gestations. Thrombin-antithrombin III (TAT) and Thrombin-Heparin co-factor II (T-HCII) concentrations were measured in first trimester maternal plasma. Cases were defined by retroplacental hematoma and/or fetal vessel thrombosis or vasculitis in the umbilical cord or chorionic plate. Outcomes were analysed with Mann-Whitney U and linear regression.


RESULTS
Concentrations of both TAT (p = 0.013) and T-HCII (p = 0.001) from maternal plasma was significantly lower in cases than in controls.


CONCLUSIONS
The development of placental inflammatory and thrombotic lesions at term may be associated with lower concentrations of thrombin-inhibitor complexes earlier in the pregnancy.
Hackney
David N
DN
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. dhackney@mail.magee.edu
Chiao
Jye-Ping
JP
Macpherson
Trevor A
TA
Simhan
Hyagriv N
HN
D000328:Adult; D000990:Antithrombin III; D016022:Case-Control Studies; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D009035:Mothers; D009994:Osmolar Concentration; D010447:Peptide Hydrolases / Q000097:blood*; D010922:Placenta Diseases / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D011261:Pregnancy Trimester, First / Q000097:blood*; D013927:Thrombosis / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult
C046193:antithrombin III-protease complex; D000990:Antithrombin III; D010447:Peptide Hydrolases