Prospective investigation of second-trimester thrombin activation and preterm birth

Objective We sought to determine if second-trimester amniotic fluid thrombin-antithrombin (TAT) complexes concentration correlates with subsequent preterm birth. Study Design A cohort of 550 women with singleton nonanomalous pregnancies undergoing second-trimester genetic amniocentesis was followed...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2012-04, Vol.206 (4), p.333.e1-333.e6
Main Authors: Vidaeff, Alex C., MD, MPH, Monga, Manju, MD, Saade, George, MD, Bishop, Karen, BS, Ramin, Susan M., MD
Format: Article
Language:English
Subjects:
Adult
Amniocentesis
amniotic fluid
Amniotic Fluid - chemistry
Antithrombin III - analysis
Antithrombin III - biosynthesis
Biological and medical sciences
Case-Control Studies
Diseases of mother, fetus and pregnancy
Enzyme Activation
Female
Gynecology. Andrology. Obstetrics
Humans
Medical sciences
Obstetrics and Gynecology
Peptide Hydrolases - analysis
Peptide Hydrolases - biosynthesis
Pregnancy
Pregnancy Trimester, Second - blood
Pregnancy. Fetus. Placenta
Premature Birth
preterm birth
Prospective Studies
Thrombin - analysis
Thrombin - biosynthesis
thrombin-antithrombin complexes
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Summary:Objective We sought to determine if second-trimester amniotic fluid thrombin-antithrombin (TAT) complexes concentration correlates with subsequent preterm birth. Study Design A cohort of 550 women with singleton nonanomalous pregnancies undergoing second-trimester genetic amniocentesis was followed up to delivery and analyzed as a nested case-control study. Cases of preterm birth (n = 52) were compared with 104 term control subjects. Amniotic fluid collected at amniocentesis was tested for TAT. Results TAT concentrations were significantly higher in women who delivered preterm (median 115.9 µg/L) than in those who did not (median 62.2 µg/L; P < .001). This difference persisted when 31 spontaneous preterm births and 21 indicated preterm births were analyzed separately. The odds ratios for preterm birth in the highest TAT quartile relative to the lowest quartile was 4.98 (95% confidence interval, 1.17–22.01; P = .007). Conclusion We found a difference in the pattern of intraamniotic thrombin generation between women destined to deliver at term and those who deliver preterm, regardless of the type of preterm birth.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2012.02.010