title: Low levels of plasma protein S, protein C and coagulation factor XII during early pregnancy and adverse pregnancy outcome.
abstract: It was the study objective to evaluate whether low levels of plasma protein S (PS) activity, free PS, protein C (PC) activity and coagulation factor XII (FXII) during early pregnancy are related to adverse pregnancy outcomes. Peripheral blood samples were obtained at 8-14 gestational weeks (GW) from a consecutive series of 1,220 women. The levels of plasma PS activity, free PS, PC activity, and FXII were measured. Cut-off values were defined as < 1st, < 5th, and < 10th percentiles of values obtained from 933 women whose pregnancies ended in normal deliveries without complications. PS activity of < 10th percentile yielded risks of pregnancy-induced hypertension (PIH) and severe PIH, while free PS level of < 5th percentile yielded a risk of pre-eclampsia. FXII level of < 1st percentile yielded a risk of premature delivery (PD) at < 34 GW. None was associated with PD at < 37 GW, fetal growth restriction or fetal loss. A multivariate analysis demonstrated that PS activity of < 10th percentile (odds ratio 5.9, 95 % confidence interval 1.7-18.1) and body mass index (BMI) ≥ 25 kg/m² (4.3, 1.1-13.3) were independent risk factors for severe PIH. Similarly, free PS level of < 5th percentile (4.4, 1.0-14.3) and BMI ≥ 25 kg/m² (4.0, 1.3-10.9) were independent risk factors for pre-eclampsia. In conclusion, women with low levels of plasma PS activity and free PS during early pregnancy might have increased risks of PIH, severe PIH or pre-eclampsia. Women with low FXII level might have an increased risk of PD at < 34 GW.
authors: Yasuhiko
authors: Y
authors: Ebina
authors: Masahiro
authors: M
authors: Ieko
authors: Sumiyoshi
authors: S
authors: Naito
authors: Gen
authors: G
authors: Kobashi
authors: Masashi
authors: M
authors: Deguchi
authors: Hisanori
authors: H
authors: Minakami
authors: Tatsuya
authors: T
authors: Atsumi
authors: Prof. Hideto Yamada, MD, PhD, Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan, Tel.: +81 78 382 6005, Fax: +81 78 382 6019, E-mail: yhideto@med.kobe-u.ac.jp.
authors: Hideto
authors: H
authors: Yamada
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D001798:Blood Proteins / Q000032:analysis*; D005174:Factor XII / Q000032:analysis*; D005175:Factor XII Deficiency / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood / Q000209:etiology; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D047928:Premature Birth / Q000097:blood / Q000209:etiology; D011446:Prospective Studies; D011486:Protein C / Q000032:analysis*; D020151:Protein C Deficiency / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D017293:Protein S; D018455:Protein S Deficiency / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; C523390:PROS1 protein, human; D011486:Protein C; D017293:Protein S; D005174:Factor XII
keywords: Factor XII; pregnancy; pregnancy-induced hypertension; premature delivery; protein C; protein S