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

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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)1671-1680
Number of pages10
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume31
Issue number13
DOIs
StatePublished - 3 Jul 2018
Externally publishedYes

Funding

FundersFunder number
Division of Intramural Research
NICHD/NIH/DHHSHHSN275201300006C
Perinatology Research Branch, Program for Perinatal Research and Obstetrics
National Institutes of Health
U.S. Department of Health and Human Services
National Institute of Child Health and Human DevelopmentZIAHD002400
Eunice Kennedy Shriver National Institute of Child Health and Human Development

    Keywords

    • Endogenous thrombin potential
    • fetal growth
    • hypertension
    • pregnancy
    • velocity index

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