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Eur J Obstet Gynecol Reprod Biol. 2016 Apr;199:132-6. doi: 10.1016/j.ejogrb.2016.02.010. Epub 2016 Feb 20.

Reduced spontaneous platelet aggregation: a novel risk factor for adverse pregnancy outcome.

Author information

1
Royal College of Surgeons in Ireland, Dept. of Obstetrics and Gynecology, Rotunda Hospital, Dublin, Ireland. Electronic address: burke.naomi@gmail.com.
2
Royal College of Surgeons in Ireland, Dept. of Obstetrics and Gynecology, Rotunda Hospital, Dublin, Ireland.
3
Dept of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.
4
Dept of Obstetrics and Gynecology, Rotunda Hospital, Dublin, Ireland.

Abstract

OBJECTIVE:

Spontaneous platelet aggregation has not been adequately assessed as a potential risk factor for adverse outcomes in pregnancy. Therefore the objective of this study was to assess spontaneous platelet aggregation (SPA), measured via a novel functional assay, as a risk factor for hypertensive disease and intra-uterine growth restriction (IUGR).

STUDY DESIGN:

This was a prospective longitudinal study. Spontaneous platelet aggregation was assessed as a marker of platelet reactivity using a modification of light transmission aggregometry. Platelet reactivity was assessed in four groups: non-pregnant healthy female volunteers (n=30), longitudinally in normal uncomplicated pregnancy (n=50), hypertensive disorder (n=40) and IUGR (n=30). The mean percentage SPA was plotted and compared across all groups.

RESULTS:

Spontaneous platelet aggregation was significantly reduced in the first trimester compared to the non-pregnant group (p-value=0.003). The mean aggregation for the hypertensive group was 1.9%, (95% CI -0.08 to 4.02) and for the IUGR group was 1.6%, (95% CI -0.6 to 3.72). Platelet aggregation in the hypertensive group was significantly reduced compared to the normal pregnant group (p<0.05). Spontaneous platelet aggregation was also reduced in the IUGR group compared to normal pregnancy (p<0.05).

CONCLUSION:

This study demonstrates that a reduction of spontaneous platelet aggregation may be a novel risk factor for adverse pregnancy outcomes such as pre-eclampsia and IUGR. The most clinically significant finding is that SPA is significantly lower in pregnancies complicated by hypertension and IUGR compared to those who had a normal pregnancy outcome. Further studies should be carried out to asses if spontaneous platelet aggregation may be a clinically useful tool for the prediction of pre-eclampsia and IUGR.

KEYWORDS:

Aggregation; Hypertension; Intra-uterine growth restriction; Normal pregnancy; Platelets; Spontaneous

PMID:
26927895
DOI:
10.1016/j.ejogrb.2016.02.010
[Indexed for MEDLINE]

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