title: Protein S deficiency complicated pregnancy in women with recurrent pregnancy loss.
abstract: This prospective study aimed to evaluate pregnancy outcome and complications in women with recurrent pregnancy loss (RPL) and protein S (PS) deficiency, who received low dose aspirin (LDA) or LDA plus heparin (LDA/H) therapies. Clinical characteristics, pregnancy outcome and complications of 38 women with two or more RPL and <60% of plasma free PS antigen were compared among three groups: antiphospholipid antibody (aPL)-negative women who received LDA (group A), aPL-negative women who received LDA/H (group B) and aPL-positive women who received LDA/H (group C). Gestational weeks (GW) at delivery in group C (median 32 GW) were earlier than 40 GW in group A and 38.5 GW in group B (p < 0.05). The birth weight in group C (median 1794 g) was less than 2855 g in group B (p < 0.05). The incidences of fetal growth restriction (37.5%), pregnancy-induced hypertension (37.5%), and preterm delivery (62.5%) in group C were higher than those (4.5%, 0%, and 4.5%, respectively) in group B (p<0.05). Women with RPL, PS deficiency, and positive aPL had high risks for adverse pregnancy outcome and complications, even when they received LDA/H therapy. Among women with RPL, PS, and negative aPL, there was no difference in these risks between LDA alone and LDA/H therapies.
authors.affiliation: a Department of Obstetrics and Gynecology , Kobe University Graduate School of Medicine , Kobe , Japan.
authors.forename: Nanae
authors.initials: N
authors.lastname: Shinozaki
authors.affiliation: a Department of Obstetrics and Gynecology , Kobe University Graduate School of Medicine , Kobe , Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Ebina
authors.affiliation: a Department of Obstetrics and Gynecology , Kobe University Graduate School of Medicine , Kobe , Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Deguchi
authors.affiliation: a Department of Obstetrics and Gynecology , Kobe University Graduate School of Medicine , Kobe , Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Tanimura
authors.affiliation: a Department of Obstetrics and Gynecology , Kobe University Graduate School of Medicine , Kobe , Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Morizane
authors.affiliation: a Department of Obstetrics and Gynecology , Kobe University Graduate School of Medicine , Kobe , Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Yamada
mesh_terms: D000026:Abortion, Habitual / Q000453:epidemiology; D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D001241:Aspirin / Q000008:administration & dosage / Q000494:pharmacology*; D001724:Birth Weight; D015897:Comorbidity; D004359:Drug Therapy, Combination; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D006493:Heparin / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D047928:Premature Birth / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D018455:Protein S Deficiency / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D017152:Antibodies, Antiphospholipid; D005343:Fibrinolytic Agents; D006493:Heparin; D001241:Aspirin
keywords: Heparin; low-dose aspirin; protein S deficiency; recurrent pregnancy loss