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 casecontrol study The New Jersey-Placental Abruption Study (20022007). 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.
All Science Journal Classification (ASJC) codes
- Pediatrics, Perinatology, and Child Health
- Obstetrics and Gynecology
- activated protein C resistance
- placental abruption
- protein C
- protein S