Protein S deficiency complicated pregnancy in women with recurrent pregnancy loss

• Published in: Gynecological endocrinology Vol. 32; no. 8; pp. 672 - 674
• Main Authors: Shinozaki, Nanae, Ebina, Yasuhiko, Deguchi, Masashi, Tanimura, Kenji, Morizane, Mayumi, Yamada, Hideto
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 02.08.2016
• Subjects: Abortion, Habitual - epidemiology; Adult; Antibodies, Antiphospholipid - blood; Aspirin - administration & dosage; Aspirin - pharmacology; Birth Weight; Comorbidity; Drug Therapy, Combination; Female; Fetal Growth Retardation - blood; Fetal Growth Retardation - drug therapy; Fetal Growth Retardation - epidemiology; Fibrinolytic Agents - administration & dosage; Fibrinolytic Agents - pharmacology; Heparin; Heparin - administration & dosage; Heparin - pharmacology; Humans; Hypertension, Pregnancy-Induced - blood; Hypertension, Pregnancy-Induced - drug therapy; Hypertension, Pregnancy-Induced - epidemiology; low-dose aspirin; Pregnancy; Pregnancy Complications, Hematologic - blood; Pregnancy Complications, Hematologic - drug therapy; Pregnancy Complications, Hematologic - epidemiology; Premature Birth - blood; Premature Birth - drug therapy; Premature Birth - epidemiology; protein S deficiency; Protein S Deficiency - blood; Protein S Deficiency - drug therapy; Protein S Deficiency - epidemiology; recurrent pregnancy loss; protein S deficiency; Heparin; low-dose aspirin; recurrent pregnancy loss
• ISSN: 0951-3590; 1473-0766; 1473-0766
• DOI: 10.3109/09513590.2016.1152239

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.