Factor VIII levels and the risk of pre-eclampsia, HELLP syndrome, pregnancy related hypertension and severe intrauterine growth retardation

Abstract

Objective: Recently, acquired as well as genetic prothrombotic factors are associated with thrombotic events. These factors have also been related to conditions of uteroplacental insufficiency such as pre-eclampsia, HELLP syndrome and severe intrauterine growth restriction (IUGR). The aim of this study was to determine whether elevated factor VIII levels are associated with uteroplacental insufficiency, in particular pre-eclampsia, HELLP syndrome or pregnancy-induced hypertension and intrauterine growth retardation. Methods: Plasma samples of 75 women with a history of pregnancy complicated by pre-eclampsia, HELLP syndrome, pregnancy induced hypertension or intrauterine growth restriction were tested for factor VIII:C (FVIII:C) levels at a minimum of 10 weeks post-partum. Laboratory results were compared to factor VIII:C levels found in a healthy control group of 272 women. Results: Mean factor VIII:C levels were similar at 123 IU/dl in both the patient group and the controls. In a logistic regression model, after adjusting for age and blood group, no effect of factor VIII:C levels on the risk of pregnancy complications was observed, with the exception of IUGR with (OR 2.9, CI 1.0-8.7) or without hypertension (OR 2.0, CI 0.7-6.4). Conclusion: If the elevated level of factor VIII would be the sole factor responsible for the increased risk observed, one would expect to find an effect of blood group on 0049-3848/$ -see front matter D

Severe pregnancy complications are associated with elevated factor VIII plasma activity

“…Further support of our hypothesis comes from several studies that showed an association between elevated factor VIII activity and repeated early pregnancy loss [17,18]. In contrast, Witsenburg et al [24] reported similar activity of factor VIII among patients with pregnancy complications and normal controls. After adjusting for several factors, there were no effects of factor VIII levels on the risk of pregnancy complications except for IUGR, both with and without hypertension (OR 2.9 and 2, respectively).…”

“…Obviously, the interpretation of these findings is limited, as the level of factor VIII is known to increase during normal pregnancy [23]. A recent study showed an association between postpartum factor VIII levels and IUGR, but not for other pregnancy complications [24]. We investigated the association between factor VIII levels and severe pregnancy complications, which are considered to result from placental vascular abnormality, that is, preeclampsia, IUGR, placental abruption and IUFD.…”

Relationship between the abo blood group and hyperemesis gravidarum, anemia, and preeclampsia

“…This research is consistent with previous studies saying that there is relationship between ABO blood group and preeclampsia, with an increased risk by 2.1-3.1 folds [27,28]. In addition, the incidence of preeclampsia is higher in individuals with non-O blood group than those with blood group O.…”

Complicações do parto e resultados perinatais em gestantes portadoras da doença de von Willebrand

“…O presente estudo revela elevada proporção de fetos com restrição de crescimento (38,5%) e de baixo peso no nascimento (38,5%). Estudos descrevem associação entre a relação do fator VIIIag/VIIIc com a restrição do crescimento fetal 22,23 , entretanto não existem estudos aprofundados em pacientes com a doença de von Willebrand. A restrição do crescimento torna o feto mais susceptível ao sofrimento fetal, exigindo vigilância intensiva do seu bem-estar, principalmente no período intraparto.…”