title: Circulating pro- and anticoagulant levels in normal and complicated primigravid pregnancies and their relationship to placental pathology.
abstract: We aimed to compare the changes in factor VIII:C, antithrombin, protein C, protein S and fibrinogen in a cohort of low-risk primigravida who developed maternal or fetal complications to those who had uncomplicated pregnancies and to correlate these findings with placental pathology. This is a case-control study of 170 cases and 122 controls selected from a prospective cohort of 1,011 low-risk primigravida. Significantly elevated levels of factor VIII:C and significantly decreased levels of antithrombin were seen in women who developed pre-eclampsia (p <0.001), placental infarction (p < 0.001) or had infants with a birth weight < 3rd centile (p < 0.001). Placental villous dysmaturity was significantly associated with raised factor VIII:C (p < 0.001). Women who developed pre-eclampsia showed elevated fibrinogen at 14 weeks (p = 0.03). Significantly higher than normal pregnancy levels of factor VIII:C, in tandem with significantly lower antithrombin levels associated with certain adverse pregnancy outcomes, may be related to underlying placental insufficiency. This is supported by associated placental findings.
authors.affiliation: Department of Obstetrics and Gynaecology, Rotunda Hospital, Dublin, Ireland. jenniferdonnelly@mac.com
authors.forename: J C
authors.initials: JC
authors.lastname: Donnelly
authors.forename: S M
authors.initials: SM
authors.lastname: Cooley
authors.forename: T A
authors.initials: TA
authors.lastname: Walsh
authors.forename: O P
authors.initials: OP
authors.lastname: Smith
authors.forename: J
authors.initials: J
authors.lastname: Gillan
authors.forename: C
authors.initials: C
authors.lastname: McMahon
authors.forename: M P
authors.initials: MP
authors.lastname: Geary
mesh_terms: D000328:Adult; D000991:Antithrombins / Q000097:blood; D016022:Case-Control Studies; D005169:Factor VIII / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D020073:Gravidity; D006801:Humans; D010922:Placenta Diseases / Q000097:blood; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011486:Protein C / Q000378:metabolism; D017293:Protein S / Q000378:metabolism
chemical_list: D000991:Antithrombins; D011486:Protein C; D017293:Protein S; D005169:Factor VIII; D005340:Fibrinogen