Page 53 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

2.2 Associations between phenotypes of preeclampsia and thrombophilia| 51
If preeclampsia was severe, we found a higher prevalence of Protein-S deficiency. Associations disappeared when testing for the other of preeclampsia. Two previous studies also found a significant association between severe preeclampsia compared to normal controls104 105.
If preeclampsia was accompanied with IUGR, we found a higher prevalence of anti-phospholipid antibodies. Yasuda et al106 found similar results in 22 women with IUGR without preeclampsia, while another study did not find this association in 25 women107. Other studies did not perform a comparative analysis108 or were unable to do so because of a 94% incidence of IUGR in their cohort109.
In early preeclampsia, we found a higher prevalence of anti-phospholipid antibodies. Another study did not show a difference in anti-phospholipid antibodies in women with preeclampsia that delivered before and after the 28th gestational week110.
In case of increased placental infarction >10% we found a higher prevalence of anti-phospholipid antibodies. No previous study tested this association.
In case of a low placental weight ≤ 5th percentile we found a higher prevalence of hyperhomocysteineamia. Only one previous study found an association between elevated homocysteine levels and placental vasculopathy138. One study showed an increased placental weight when folic acid supplementation was started preconceptionally139. Since folic acid lowers homocysteine levels, these and our results suggest that elevated homocysteine levels could impair placental growth capability.
We found no association between HELLP and any kind of thrombophilia, unlike other studies99 105 116. The factor analysis did not show any association in the continuous results also.