Altered Platelet Function in Intrauterine Growth Restriction: A Cause or a Consequence of Uteroplacental Disease?

Sieglinde M. Müllers; Naomi Burke; Karen Flood; Jonathan Cowman; Hugh O'connor; Brian Cotter; Morgan Kearney; Mark Dempsey; Patrick Dicker; Elizabeth Tully; Michael P. Geary; Dermot Kenny; Fergal D. Malone

doi:10.1055/s-0036-1572428

American Journal of Perinatology, Table of Contents

Am J Perinatol 2016; 33(08): 791-799
DOI: 10.1055/s-0036-1572428

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Altered Platelet Function in Intrauterine Growth Restriction: A Cause or a Consequence of Uteroplacental Disease?

Sieglinde M. Müllers

¹Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland

,

Naomi Burke

¹Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland

,

Karen Flood

¹Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland

,

Jonathan Cowman

²Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland

,

Hugh O'connor

¹Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland

,

Brian Cotter

²Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland

,

Morgan Kearney

³Center for Women's Health Research, University of North Caroline, Chapel Hill, North Carolina

,

Mark Dempsey

¹Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland

,

Patrick Dicker

⁴Department of Epidemiology and Public Health, Royal College of Surgeons in Ireland, Dublin, Ireland

,

Elizabeth Tully

¹Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland

,

Michael P. Geary

⁵Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto, Canada

,

Dermot Kenny

²Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland

,

Fergal D. Malone

¹Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland

› Author Affiliations

Abstract

Objective A limited number of platelet function studies in intrauterine growth restriction (IUGR) have yielded conflicting results. We sought to evaluate platelet reactivity in IUGR using a novel platelet aggregation assay.

Study Design Pregnancies with IUGR were recruited from 24 weeks' gestation (estimated fetal weight < 10th centile) and had platelet function testing performed after diagnosis. A modification of light transmission aggregometry created dose–response curves of platelet reactivity in response to multiple agonists at differing concentrations. Findings were compared with healthy third trimester controls. IUGR cases with a subsequent normal birth weight were analyzed separately.

Results In this study, 33 pregnancies retained their IUGR diagnosis at birth, demonstrating significantly reduced platelet reactivity in response to all agonists (arachidonic acid, adenosine diphosphate, collagen, thrombin receptor–activating peptide, and epinephrine) when compared with 36 healthy pregnancy controls (p < 0.0001). Similar results were obtained for cases demonstrating an increasing in utero growth trajectory. When IUGR preceded preeclampsia or gestational hypertension, platelet function was significantly reduced compared with normotensive IUGR.

Conclusion Using this comprehensive platelet assay, we have demonstrated a functional impairment of platelets in IUGR. This may reflect platelet-derived placental growth factor release. Further evaluation of platelet function may aid in the development of future platelet-targeted therapies for uteroplacental disease.

Keywords

platelet function - platelet reactivity - light transmission aggregometry - agonist - intrauterine growth restriction

Full Text

References

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