The pattern and magnitude of "in vivo thrombin generation" differ in women with preeclampsia and in those with SGA fetuses without preeclampsia.

Abstract

OBJECTIVE:

We aimed to determine the differences in the pattern and magnitude of thrombin generation between patients with preeclampsia (PE) and those with a small-for-gestational-age (SGA) fetus.

METHODS:

This cross-sectional study included women in the following groups: (1) normal pregnancy (NP) (n = 49); (2) PE (n = 56); and (3) SGA (n = 28). Maternal plasma thrombin generation (TGA) was measured, calculating: (a) lag time (LT); (b) velocity index (VI); (c) peak thrombin concentration (PTC); (d) time-to-peak thrombin concentration (TPTC); and (e) endogenous thrombin potential (ETP).

RESULTS:

(1) The median TPTC, VI, and ETP differed among the groups (p = .001, p = .006, p < .0001); 2) the median ETP was higher in the PE than in the NP (p < .0001) and SGA (p = .02) groups; 3) patients with SGA had a shorter median TPTC and a higher median VI than the NP (p = .002, p = .012) and PE (p < .0001, p = .006) groups.

CONCLUSIONS:

(1) Patients with PE had higher in vivo thrombin generation than women with NP and those with an SGA fetus; (2) the difference in TGA patterns between PE and SGA suggests that the latter group had faster TGA, while patients with PE had a longer reaction, generating more thrombin. This observation is important for the identification of a subset of patients who might benefit from low molecular-weight heparin.

• Authors: Offer Erez, Roberto Romero, Edi Vaisbuch, Juan Pedro Kusanovic, Shali Mazaki-Tovi, Tinnakorn Chaiworapongsa, Francesca Gotsch, Pooja Mittal, Samuel S Edwin, Chia-Ling Nhan-Chang, Nandor Gabor Than, Chong Jai Kim, Sun Kwon Kim, Lami Yeo, Moshe Mazor, Sonia S Hassan
• Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (J Matern Fetal Neonatal Med) Vol. 31 Issue 13 Pg. 1671-1680 (Jul 2018) ISSN: 1476-4954 [Electronic] England
• PMID: 28438061 (Publication Type: Journal Article)

Chemical References

• Lipoproteins
• lipoprotein-associated coagulation inhibitor
• Thrombin

Topics

• Adult
• Case-Control Studies
• Female
• Gestational Age
• Humans
• Infant, Newborn
• Infant, Small for Gestational Age (blood)
• Lipoproteins (blood)
• Pre-Eclampsia (blood)
• Pregnancy
• Thrombin (analysis, biosynthesis)
• Young Adult