Coagulation and fibrinolysis in smoking and nonsmoking pregnant women

Abstract

Objective To assess the effects of smoking during pregnancy on coagulation and fibrinolysis. Design A cross‐sectional study. Setting A teaching hospital in Heerlen, The Netherlands. Results Parameters of coagulation activation increased significantly with gestational age. The values presented are median values. Prothrombin fragment 1+2 increased from 0.8 to 25 nmol/l in the nonsmoking group of pregnant women and from 1.0 to 1.8 nmol/l in the smoking group. Thrombin‐antithrombin III (TAT) levels increased from 2.2 to 9.9 μg/l in the nonsmoking group and from 3.1 to 8.5 μg/1 in the smoking group. Parameters of fibrinolysis showed a different picture. Plasminogen levels in both groups rose significantly in the first half of gestation reaching a plateau in the second half. The α2‐antiplasmin levels remained constant in both groups, although the smokers started with significantly higher levels: 119 versus 105 % in the nonsmokers. The D‐dimer levels rose significantly in both groups: from 278 to 847 μg/ml in the nonsmokers and from 215 to 520 μg/ml in the smokers. They were significantly lower in the smoking group from the 11th up to the 40th weeks. The D‐dimer/TAT ratio was significantly higher in the nonsmokers. Conclusions In smoking pregnant women the activated coagulation process was not counterbalanced by an adequate increase of fibrinolysis which was the case in the nonsmokers.

Urinary tissue factor: a potential marker of disease

“…92,[108][109][110][111][112][113] Heavy cigarette smokers also have higher total leukocyte counts than nonsmokers. 114,115 However, the effect of smoking on uTF activity has only recently been assessed and no significant association between the two has been found.…”

Fibrin-Type Fibrinoid in Human Placenta: A Stereological Analysis of Its Association With Intervillous Volume and Villous Surface Area

“…Changes in haemostatic factors also occur in abnormal pregnancies including those associated with pre-eclampsia (Condie and Ogston, 1976;Kobayashi and Terao, 1987), maternal smoking (Mercelina-Roumans et al, 1996) and type 2 diabetes mellitus (Quinn and Grant, 1999). The reduced FTF content in high-altitude placentas cannot be explained by the changes in IVS volume or the accompanying alteration in the plasma fraction which results from elevated haematocrits (Haas,1980).…”

“…High Altitude Variable Amerindian (n = 10) Non-indian (n = 14) Amerindian (n = 16) Non-indian (n = 28) Birthweight (g) 3425 (138) 3226 (104) 3142 (89) 2927 (59) Placental weight (g) 460 (32) 456 (28) 480 (17) 454 (15) IVS volume (ml) 187 (25) 173 (10) 256 ( There is evidence from normal pregnancies that haemostatic factors, and hence the coagulationfibrinolysis steady state, vary (Mercelina-Roumans et al, 1996). Especially during the last trimester, the coagulation cascade is stimulated whilst fibrinolytic activity decreases (Shaper et al, 1965;Fletcher et al, 1979;Oliver et al, 1976).…”

Global Screening of Human Cord Blood Proteomes for Biomarkers of Toxic Exposure and Effect

“…We identified 17 candidate biomarkers of toxic in utero exposure (Table 2), 14 of which previously had been linked to cigarette smoking as determined in a literature review (Belch et al 1984; Calori et al 1996; Capuano et al 2006; Cervi and Feighery 1991; Craig et al 1989; D’Souza et al 1978; Fager et al 1980; Goldenberg et al 1991; Hsieh et al 1984; Iscan et al 1997; Kawada 2004; Kew et al 1987; Kim et al 2006; Koethe et al 1995; Mercelina-Roumans et al 1996, 1997; Steinmetz et al 1988; Van Tiel et al 2002; Yuan et al 2007). Of these, 11 were previously described following targeted measurements in blood from newborns, whereas the remaining ones were from experimental models (e.g., purified proteins, animal studies) or from studies of adults who had either long-term, high-level exposures or diseases associated with cigarette smoke exposure.…”