title: Altered Platelet Function in Intrauterine Growth Restriction: A Cause or a Consequence of Uteroplacental Disease?
abstract: Objective A limited number of platelet function studies in intrauterine growth restriction (IUGR) have yielded conflicting results. We sought to evaluate platelet reactivity in IUGR using a novel platelet aggregation assay. Study Design Pregnancies with IUGR were recruited from 24 weeks' gestation (estimated fetal weight < 10th centile) and had platelet function testing performed after diagnosis. A modification of light transmission aggregometry created dose-response curves of platelet reactivity in response to multiple agonists at differing concentrations. Findings were compared with healthy third trimester controls. IUGR cases with a subsequent normal birth weight were analyzed separately. Results In this study, 33 pregnancies retained their IUGR diagnosis at birth, demonstrating significantly reduced platelet reactivity in response to all agonists (arachidonic acid, adenosine diphosphate, collagen, thrombin receptor-activating peptide, and epinephrine) when compared with 36 healthy pregnancy controls (p < 0.0001). Similar results were obtained for cases demonstrating an increasing in utero growth trajectory. When IUGR preceded preeclampsia or gestational hypertension, platelet function was significantly reduced compared with normotensive IUGR. Conclusion Using this comprehensive platelet assay, we have demonstrated a functional impairment of platelets in IUGR. This may reflect platelet-derived placental growth factor release. Further evaluation of platelet function may aid in the development of future platelet-targeted therapies for uteroplacental disease.
authors.affiliation: Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland.
authors.forename: Sieglinde M
authors.initials: SM
authors.lastname: Müllers
authors.affiliation: Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland.
authors.forename: Naomi
authors.initials: N
authors.lastname: Burke
authors.affiliation: Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland.
authors.forename: Karen
authors.initials: K
authors.lastname: Flood
authors.affiliation: Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cowman
authors.affiliation: Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland.
authors.forename: Hugh
authors.initials: H
authors.lastname: O'connor
authors.affiliation: Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Brian
authors.initials: B
authors.lastname: Cotter
authors.affiliation: Center for Women's Health Research, University of North Caroline, Chapel Hill, North Carolina.
authors.forename: Morgan
authors.initials: M
authors.lastname: Kearney
authors.affiliation: Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland.
authors.forename: Mark
authors.initials: M
authors.lastname: Dempsey
authors.affiliation: Department of Epidemiology and Public Health, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Dicker
authors.affiliation: Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Tully
authors.affiliation: Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto, Canada.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Geary
authors.affiliation: Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Dermot
authors.initials: D
authors.lastname: Kenny
authors.affiliation: Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland.
authors.forename: Fergal D
authors.initials: FD
authors.lastname: Malone
mesh_terms: D000328:Adult; D001792:Blood Platelets / Q000502:physiology*; D016022:Case-Control Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D010972:Platelet Activating Factor / Q000378:metabolism / Q000494:pharmacology; D010979:Platelet Function Tests; D011225:Pre-Eclampsia / Q000097:blood; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011263:Pregnancy Trimester, Third; D055815:Young Adult
chemical_list: D010972:Platelet Activating Factor