Tissue factor pathway inhibitor for prediction of placenta-mediated adverse pregnancy outcomes in high-risk women: AngioPred study.
OBJECTIVE
The study aimed to evaluate if the rate of tissue factor pathway inhibitor during pregnancy and following delivery could be a predictive factor for placenta-mediated adverse pregnancy outcomes in high-risk women.


METHODS
This was a prospective multicentre cohort study of 200 patients at a high risk of occurrence or recurrence of placenta-mediated adverse pregnancy outcomes conducted between June 2008 and October 2010. Measurements of tissue factor pathway inhibitor resistance (normalized ratio) and tissue factor pathway inhibitor activity were performed for the last 72 patients at 20, 24, 28, 32, and 36 weeks of gestation and during the postpartum period.


RESULTS
Overall, 15 patients presented a placenta-mediated adverse pregnancy outcome. There was no difference in normalized tissue factor pathway inhibitor ratios between patients with and without placenta-mediated adverse pregnancy outcomes during pregnancy and in the post-partum period. Patients with placenta-mediated adverse pregnancy outcomes had tissue factor pathway inhibitor activity rates that were significantly higher than those in patients without at as early as 24 weeks of gestation. The same results were observed following delivery.


CONCLUSIONS
Among high-risk women, the tissue factor pathway inhibitor activity of patients with gestational vascular complications is higher than that in other patients. Hence, these markers could augment a screening strategy that includes an analysis of angiogenic factors as well as clinical and ultrasound imaging with Doppler measurement of the uterine arteries.
Department of Gynaecology and Obstetrics, University Hospital, Saint Etienne, France.
Aurélie
A
Di Bartolomeo
Department of Gynaecology and Obstetrics, University Hospital, Saint Etienne, France.|INSERM UMR 1059, Saint Etienne University Jean Monnet, Saint Etienne, France.
Céline
C
Chauleur
Laboratory of Haematology, University Hospital, Nîmes, France.|Research Unit EA2992, Montpellier University, Montpellier, France.
Jean-Christophe
JC
Gris
INSERM UMR 1059, Saint Etienne University Jean Monnet, Saint Etienne, France.|Clinical Pharmacology Unit, University Hospital, Saint Etienne, France.
Céline
C
Chapelle
Department of Gynaecology and Obstetrics, University Hospital, Saint Etienne, France.
Edouard
E
Noblot
INSERM UMR 1059, Saint Etienne University Jean Monnet, Saint Etienne, France.|Clinical Pharmacology Unit, University Hospital, Saint Etienne, France.
Silvy
S
Laporte
Department of Gynaecology and Obstetrics, University Hospital, Saint Etienne, France.|INSERM UMR 1059, Saint Etienne University Jean Monnet, Saint Etienne, France.
Tiphaine
http://orcid.org/0000-0002-4408-6075
T
Raia-Barjat
D000328:Adult; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood / Q000175:diagnosis; D006801:Humans; D007231:Infant, Newborn; D008074:Lipoproteins / Q000097:blood*; D010920:Placenta / Q000098:blood supply* / Q000503:physiopathology*; D021041:Placental Circulation / Q000502:physiology; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk / Q000097:blood*; D011446:Prospective Studies; D014599:Uterus / Q000098:blood supply
D015415:Biomarkers; D008074:Lipoproteins; C051928:lipoprotein-associated coagulation inhibitor