Elevated plasma levels of factor VIII in women with early recurrent miscarriage

Abstract

Aims: Inherited and acquired thrombophilia have been found to be associated with recurrent pregnancy loss. This paper examines whether or not elevated factor (F)VIII:Cplasma levels, which have been demonstrated to be an independent risk factor for venous thromboembolism, are a risk factor for early recurrent miscarriages also. Patients and methods: Consecutive women referred to our clinic with a history of early recurrent abortion (at least three pregnancy losses before week 13 of gestation) were eligible for the study. Exclusion criteria were endocrine, immunological, anatomical and genetic causes of embryo demise, as well as any thrombophilic abnormality, either congenital or acquired, or a personal or familial history of venous thromboembolism. FVIII:Cplasma levels were de-termined in 51 cases and in 51 controls matched for age, ethnicity and blood group. Results: The mean FVIII:Clevel in the control subjects was 106.8 IU dL -1, compared with 128.2 IU dL -1 in the patients group (P=0.0002). Thirteen (25.5%) of the 51 patients had FVIII:Cvalues exceeding the 90th centile of the control population (145 IU dL -1), compared with four subjects in the control group (x 2=4.52; P=0.033; odds ratio =4.02, 95% confidence interval 1.09, 16.05). No cases with increase in FVIII:Clevels attributable to an acute-phase reaction, as assessed by C-reactive protein plasma con-centration, were found. Conclusions: We found FVIII:Clevels significantly higher in women with early recurrent miscarriage compared with controls. This finding suggests a possible asso-ciation between this thrombophilic condition and early repro-ductive failures. © 2003 International Society on Thrombosis and Haemostasis.