Abstract
Objective. To examine the association between maternal thrombophilia associated with anticoagulation (proteins C and S and activated protein C resistance ratio, APCR) and risk of placental abruption.
Methods. Data were derived from a case–control study – The New Jersey-Placental Abruption Study (2002–2007). Maternal blood was collected from abruption cases and controls and was assayed for the thrombophilias. Decreased protein C, S and APCR was defined as values <5% and <10% among controls.
Results. Of a total of 132 cases and 127 controls, 3 were heterozygous for the factor V Leiden mutation (1 case and 2 controls). Mean (± standard deviation) protein C (114.2 ± 25.6 vs. 121.4 ± 27.6; P = 0.009), protein S (39.9 ± 18.4 vs. 35.7 ± 15.2; P = 0.043) and APCR (2.86 ± 0.29 vs. 2.88 ± 0.27; P = 0.039) were different between cases and controls. Abruption cases were associated with an odds ratio of 3.2 (95% CI 1.2, 9.9) in relation to decreased protein C (<Fifth centile). Decreases in both protein S and APCR ratio were not associated with abruption.
Conclusions. A decrease in protein C was associated with an increased risk for abruption, suggesting an important role for the physiologic anticoagulant system in the etiology of placental abruption.
Acknowledgement
This research was funded by the National Institutes of Health (HD038902) awarded to Dr. Ananth.