title: Association of elevated soluble P-selectin levels with fetal loss in women with a history of venous thromboembolism.
abstract: BACKGROUND
  An association between pregnancy complications such as fetal loss with inherited and acquired thrombophilic defects has frequently been reported. Recently, the cell adhesion molecule P-selectin has been identified to be a strong risk factor for venous thromboembolism (VTE).
  
  
  METHODS
  The aim of our study was to investigate whether soluble P-selectin (sP-selectin) is also associated with fetal loss (e.g. miscarriage or stillbirth) in 304 women (median age [25th-75th percentile]: 45 [37-54] years) with a history of VTE, in whom data on pregnancy-associated complications had been evaluated. At the time of sP-selectin measurement none of the women was pregnant or had an acute VTE.
  
  
  RESULTS
  The prevalence of miscarriage was 21.4% and that of stillbirth was 4.6%. The median sP-selectin level of the total study population was 38.0 [31.7-44.4] ng/mL. In subjects with elevated sP-selectin levels (defined as sP-selectin ≥44.4ng/mL, representing the 75th percentile of levels in the study population) the prevalence of stillbirth was significantly higher compared to those with lower levels (10.5% vs. 2.6%, p=0.008), whereas no statistically significant difference in the prevalence of miscarriage was observed between women with and without elevated sP-selectin (17.1% vs. 22.9%, p=0.303). The odds ratio [95% CI] of elevated sP-selectin was 4.2 [1.5-12.7] for stillbirth and 0.7 [0.4-1.3] for miscarriage.
  
  
  CONCLUSIONS
  Elevated sP-selectin plasma levels were associated with a 4.2-fold risk for stillbirth in women with a history of VTE. Our data support a possible role of P-selectin in late pregnancy loss.
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Austria.
authors.forename: Cihan
authors.initials: C
authors.lastname: Ay
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kaider
authors.forename: Silvia
authors.initials: S
authors.lastname: Koder
authors.forename: Peter
authors.initials: P
authors.lastname: Husslein
authors.forename: Ingrid
authors.initials: I
authors.lastname: Pabinger
mesh_terms: D000022:Abortion, Spontaneous / Q000097:blood*; D000328:Adult; D005260:Female; D005313:Fetal Death / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood*; D012189:Retrospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000097:blood*; D055815:Young Adult
chemical_list: D019007:P-Selectin