OBJECTIVE: Protein Z, a vitamin K-dependent plasma protein, has an important role in the regulation of the coagulation cascade. Protein Z deficiency has been associated with unexplained pregnancy loss and adverse pregnancy outcome in patients with thrombophilia. This study was conducted to determine if preeclampsia (PE), small for gestational age (SGA), and fetal demise are associated with changes in maternal plasma concentrations of protein Z. STUDY DESIGN: This cross-sectional study included normal pregnant women (N = 71), patients with PE (N = 130), patients who delivered an SGA neonate (N = 58), and patients with fetal demise (N = 58). Maternal plasma protein Z concentrations were measured by a sensitive and specific immunoassay. Protein Z deficiency was defined as maternal plasma concentrations <or=5th percentile of the normal pregnancy group (<or=1.59 microg/mL). Non-parametric statistics were used for analysis. RESULTS: (1) Patients with PE had a lower median plasma concentration of protein Z than normal pregnant women (PE: median 1.6 microg/mL, range 0.2-3.3 microg/mL vs. normal pregnancy: median 2.4 microg/mL, range 1.1-3.4 microg/mL; p < 0.0001); (2) patients with an SGA neonate (median 2.3 microg/mL, range 0.2-3.8 microg/mL) and fetal demise (median 2.6 microg/mL, range 0.2-4.3 g/mL) did not have significantly different median protein Z concentrations from normal pregnant women (p > 0.05); and (3) women in the PE and fetal demise groups had significantly higher rates of protein Z deficiency than those with normal pregnancy outcome. CONCLUSIONS: (1) PE, but not SGA or fetal demise, is associated with a significantly lower maternal median plasma concentration of protein Z than normal pregnancy, and (2) a high rate of protein Z deficiency is observed in patients with PE and fetal demise.
OBJECTIVE: Protein Z, a vitamin K-dependent plasma protein, has an important role in the regulation of the coagulation cascade. Protein Z deficiency has been associated with unexplained pregnancy loss and adverse pregnancy outcome in patients with thrombophilia. This study was conducted to determine if preeclampsia (PE), small for gestational age (SGA), and fetal demise are associated with changes in maternal plasma concentrations of protein Z. STUDY DESIGN: This cross-sectional study included normal pregnant women (N = 71), patients with PE (N = 130), patients who delivered an SGA neonate (N = 58), and patients with fetal demise (N = 58). Maternal plasma protein Z concentrations were measured by a sensitive and specific immunoassay. Protein Z deficiency was defined as maternal plasma concentrations <or=5th percentile of the normal pregnancy group (<or=1.59 microg/mL). Non-parametric statistics were used for analysis. RESULTS: (1) Patients with PE had a lower median plasma concentration of protein Z than normal pregnant women (PE: median 1.6 microg/mL, range 0.2-3.3 microg/mL vs. normal pregnancy: median 2.4 microg/mL, range 1.1-3.4 microg/mL; p < 0.0001); (2) patients with an SGA neonate (median 2.3 microg/mL, range 0.2-3.8 microg/mL) and fetal demise (median 2.6 microg/mL, range 0.2-4.3 g/mL) did not have significantly different median protein Z concentrations from normal pregnant women (p > 0.05); and (3) women in the PE and fetal demise groups had significantly higher rates of protein Z deficiency than those with normal pregnancy outcome. CONCLUSIONS: (1) PE, but not SGA or fetal demise, is associated with a significantly lower maternal median plasma concentration of protein Z than normal pregnancy, and (2) a high rate of protein Z deficiency is observed in patients with PE and fetal demise.
Authors: Raymond W Redline; Theonia Boyd; Valarie Campbell; Scott Hyde; Cynthia Kaplan; T Yee Khong; Heather R Prashner; Brenda L Waters Journal: Pediatr Dev Pathol Date: 2004-03-17
Authors: Pooja Mittal; Roberto Romero; Adi L Tarca; Sorin Draghici; Chia-Ling Nhan-Chang; Tinnakorn Chaiworapongsa; John Hotra; Ricardo Gomez; Juan Pedro Kusanovic; Deug-Chan Lee; Chong Jai Kim; Sonia S Hassan Journal: Am J Obstet Gynecol Date: 2011-02 Impact factor: 8.661
Authors: Pooja Mittal; Roberto Romero; Adi L Tarca; Juan Gonzalez; Sorin Draghici; Yi Xu; Zhong Dong; Chia-Ling Nhan-Chang; Tinnakorn Chaiworapongsa; Stephen Lye; Juan Pedro Kusanovic; Leonard Lipovich; Shali Mazaki-Tovi; Sonia S Hassan; Sam Mesiano; Chong Jai Kim Journal: J Perinat Med Date: 2010-07-14 Impact factor: 1.901