Tissue factor activity in women with preeclampsia or SGA: a potential explanation for the excessive thrombin generation in these syndromes

Offer Erez, Roberto Romero*, Edi Vaisbuch, Nandor Gabor Than, Juan Pedro Kusanovic, Shali Mazaki-Tovi, Francesca Gotsch, Pooja Mittal, Zhong Dong, Tinnakorn Chaiworapongsa, Chong Jai Kim, Chia Ling Nhan-Chang, Sun Kwon Kim, Lami Yeo, Moshe Mazor, Sonia S. Hassan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The aim of this study was to determine whether the activity of tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in the plasma of women with preeclampsia (PE) and small for gestational age (SGA) neonate differ from that of normal pregnant women and whether they are related to specific placental lesions. Methods: This cross-sectional study included the following groups: (1) normal pregnancy (n = 68); (2) PE (n= 128); and (3) SGA (n = 56). Maternal plasma TF and TFPI activity was determined with chromogenic assays. Results: (1) The median maternal plasma TF activity, but not TFPI activity, differed among the study groups (p <.0001 and p =.4, respectively); (2) patients with PE had a higher median maternal plasma TF activity than women with normal pregnancies (p <.0001) and mothers with SGA fetuses (p =.002); (3) among patients with PE, those with distal villous hypoplasia had a higher median maternal TF activity than those without these placental lesions (p =.018); and (4) following adjustment for confounding variables, maternal plasma TF and TFPI activity were not associated with an SGA neonate. Conclusions: Plasma TF activity is higher in women with PE than in those with SGA or normal pregnancies. We propose that these changes may be responsible, at least in part, for the increased in-vivo thrombin generation observed in this obstetrical syndrome.

Original languageEnglish
Pages (from-to)1568-1577
Number of pages10
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume31
Issue number12
DOIs
StatePublished - 18 Jun 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

    • Early-onset preeclampsia
    • extrinsic pathway of coagulation
    • maternal underperfusion
    • obstetrical syndromes
    • thrombin generation

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