Soluble P-selectin levels during normal pregnancy: a longitudinal study

Abstract

Objective To investigate soluble P-selectin (sP-selectin) levels and platelet parameters in normal pregnant women compared with non-pregnant control subjects. Design A longitudinal case -control study.Setting Obstetric outpatient clinic in the Jubilee Maternity Hospital, Belfast.Population One hundred and twenty normal pregnant women and 41 non-pregnant age-matched control subjects. Methods The plasma concentration of sP-selectin in pregnant women sampled at 12, 20 and 35 weeks of gestation, and, in a subgroup at three days postpartum, and non-pregnant controls sampled in parallel, was determined using a commercial quantitative sandwich immunoassay kit. Platelet parameters on each blood sample were also recorded using a SYSMEX SE 9500 analyser. Main outcome measures Plasma sP-selectin as a measure of platelet activation in normal pregnancy.Results Soluble P-selectin was significantly higher in pregnant women than in non-pregnant control subjects at 20 and 35 weeks of gestation, ( P < 0.01, and P < 0.001, respectively). Correlation analyses showed positive correlation between sP-selectin and platelet count in pregnant women at 20 and 35 weeks of gestation (r ¼ 0.247, P < 0.05 and r ¼ 0.360, P < 0.001, respectively). Soluble P-selectin concentration per platelet was also significantly higher in pregnant women than in non-pregnant control subjects at 20 and 35 weeks of gestation ( P < 0.001). Conclusions Our results show that sP-selectin concentration is significantly higher in the second and third trimester of pregnancy when compared with non-pregnant control subjects sampled in parallel. This finding clarifies previous conflicting results on platelet activation in normal pregnancy, and is in agreement with those earlier studies which reported, using other methods, increased platelet activation in normal pregnancy.

Platelet reactivity in twin pregnancies

“…Instead, "early lifting of restriction that works to reduce platelet reactivity in twin pregnancy" may be more appropriate to describe our observations. In this study, the 3 rd trimester sP-selectin level was significantly higher compared to those of 1 st and 2 nd trimester in singleton pregnancy, partly consistent with results of previous study by Holmes et al [29] in which 2 nd and 3 rd trimester, but not 1 st trimester sP-selectin levels were significantly higher than that in non-pregnant control women. In addition, the 3 rd trimester sP-selectin per platelet was significantly higher in twin than singleton pregnancies in this study (Fig.…”

Platelet reactivity changes significantly throughout all trimesters of pregnancy compared with the nonpregnant state: a prospective study

“…For example, some studies have described hyper-reactive platelets or activated platelets. Holmes and colleagues 8 performed a longitudinal study and measured levels of soluble P-selectin. P-Selectin is a biomarker of platelet activation that is shed by de-granulated platelets.…”

Platelet aggregation in citrated whole blood of the first trimester of pregnancy

“…Physiological hyperfibrinogenemia in pregnancy concomitant with possible increased platelet reactivity may partly explain the hypercoagulable state in pregnancy. Early studies regarding platelet parameters in pregnancy suggested enhanced platelet destruction accompanied by increased platelet production [11][12][13][14]. However, previous studies examining platelet activation during normal pregnancy yielded conflicting results-some reported increased activation [13,15,16], while others reported no change [17,18].…”

“…Early studies regarding platelet parameters in pregnancy suggested enhanced platelet destruction accompanied by increased platelet production [11][12][13][14]. However, previous studies examining platelet activation during normal pregnancy yielded conflicting results-some reported increased activation [13,15,16], while others reported no change [17,18]. In addition, a recent report suggested that platelet reactivity to collagen was significantly reduced during the first trimester of pregnancy compared with that in non-pregnant controls [19].…”