Prevalence of low antithrombin levels in preeclamptic women and perinatal outcome

Objective. The aim of this study is to evaluate the prevalence of low antithrombin levels in our population in order to assess an intervention trial feasibility. Methods. This is a retrospective study. A database was created by using queries to find out medical records of patients requiring hospitalization for preeclampsia or gestational hypertension or superimposed preeclampsia to chronic hypertension at Modena University Hospital between June 2015 and July 2019. Results. We screened 11845 deliveries. Overall, 221 (1.9%) cases of preeclampsia were identified. Antithrombin level was available for 201 women, thus included in the analysis. Median antithrombin value was 87% (IQ range: 77-98). The prevalence of low antithrombin levels was 9%. Antithrombin < 80% was found in 21% of the subjects. The remnant showed normal values. Median antithrombin was significantly lower in severe respect with mild preeclampsia (83% ± 14 vs 89% ± 14, p = 0.003). The rate of small for gestational age was significantly higher in low antithrombin levels group (44.4% vs 22.4%, p = 0.042). Considering mean values, antithrombin levels were also significantly lower in case of small for gestational age (84% ± 14 vs 89% ± 14; p = 0.040).

[1]  Li Lin,et al.  Potential Value of Coagulation Parameters for Suggesting Preeclampsia During the Third Trimester of Pregnancy , 2017, The American journal of the medical sciences.

[2]  A. D’Angelo,et al.  High dose antithrombin supplementation in early preeclampsia: A randomized, double blind, placebo-controlled study. , 2016, Thrombosis research.

[3]  Y. Matsuda,et al.  Plasma antithrombin levels correlate with albumin and total protein in gestational hypertension and preeclampsia. , 2014, Pregnancy hypertension.

[4]  L. Magee,et al.  The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. , 2014, Pregnancy hypertension.

[5]  K. Joseph,et al.  Incidence of preeclampsia: risk factors and outcomes associated with early- versus late-onset disease. , 2013, American journal of obstetrics and gynecology.

[6]  R. Romero,et al.  Preeclampsia: a link between trophoblast dysregulation and an antiangiogenic state. , 2013, The Journal of clinical investigation.

[7]  T. Lindahl,et al.  Biomarkers of Coagulation, Inflammation, and Angiogenesis are Independently Associated with Preeclampsia , 2012, American journal of reproductive immunology.

[8]  J. Higgins,et al.  Hemostasis in Pre-Eclampsia , 2011, Seminars in thrombosis and hemostasis.

[9]  F. Facchinetti,et al.  Antithrombin plasma levels decrease is associated with preeclampsia worsening , 2007, International journal of laboratory hematology.

[10]  H. Sameshima,et al.  Antithrombin improves fetal condition in women with severe pre‐eclampsia before 32 weeks of gestation; a randomized, double‐blind, placebo‐controlled trial , 2007, The journal of obstetrics and gynaecology research.

[11]  T. Terao,et al.  Treatment of severe preeclampsia with antithrombin concentrate: results of a prospective feasibility study. , 2003, Seminars in thrombosis and hemostasis.

[12]  D. Royston,et al.  Thrombin generation and its inhibition: a review of the scientific basis and mechanism of action of anticoagulant therapies. , 2002, British journal of anaesthesia.

[13]  James J. Walker,et al.  Pre-eclampsia , 2000, The Lancet.

[14]  M. Asami,et al.  Efficacy of Antithrombin Replacement Therapy in Severe Early-Onset Preeclampsia , 1999, Seminars in thrombosis and hemostasis.

[15]  P. Sandset,et al.  Hemostatic variables as independent predictors for fetal growth retardation in preeclampsia , 1999, Acta obstetricia et gynecologica Scandinavica.

[16]  E. Carreras,et al.  Coagulation and Fibrinolytic Parameters in Normal Pregnancy and in Pregnancy Complicated by Intrauterine Growth Retardation , 1998, American journal of perinatology.

[17]  Carl P. Weiner,et al.  The Mechanism of Reduced Antithrombin ?I Activity in Women With Preeclampsia , 1988, Obstetrics and gynecology.

[18]  Z. Hagay,et al.  Plasma antithrombin III levels in pre‐eclampsia and chronic hypertension , 1988, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.