Obstetric outcomes in pregnant COVID-19 women: the imbalance of von Willebrand factor and ADAMTS13 axis.

Autor: Grandone E; Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. 'Casa Sollievo della Sofferenza', Viale Cappuccini, 71013, Foggia, S. Giovanni Rotondo, Italy. e.grandone@operapadrepio.it.; Ob/Gyn Department of The First I.M. Sechenov Moscow State Medical University, Moscow, Russia. e.grandone@operapadrepio.it.; Ob/Gyn Institute, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy. e.grandone@operapadrepio.it., Vimercati A; Ob/Gyn Institute, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Bari, Italy., Sorrentino F; Ob/Gyn Institute, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy., Colaizzo D; Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. 'Casa Sollievo della Sofferenza', Viale Cappuccini, 71013, Foggia, S. Giovanni Rotondo, Italy., Ostuni A; Immunohematology and Transfusion Medicine Service, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, University of Bari 'Aldo Moro', Bari, Italy.; Struttura Regionale Coordinamento Puglia, Bari, Italy., Ceci O; Ob/Gyn Institute, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Bari, Italy., Capozza M; Neonatal Intensive Care Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Bari, Italy., Tiscia G; Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. 'Casa Sollievo della Sofferenza', Viale Cappuccini, 71013, Foggia, S. Giovanni Rotondo, Italy., De Laurenzo A; Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. 'Casa Sollievo della Sofferenza', Viale Cappuccini, 71013, Foggia, S. Giovanni Rotondo, Italy., Mastroianno M; Scientific Direction, Fondazione I.R.C.C.S. 'Casa Sollievo della Sofferenza', Foggia, S. Giovanni Rotondo, Italy., Cappucci F; Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. 'Casa Sollievo della Sofferenza', Viale Cappuccini, 71013, Foggia, S. Giovanni Rotondo, Italy., Fischetti L; Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. 'Casa Sollievo della Sofferenza', Viale Cappuccini, 71013, Foggia, S. Giovanni Rotondo, Italy., Margaglione M; Medical Genetics, University of Foggia, Foggia, Italy., Cicinelli E; Ob/Gyn Institute, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Bari, Italy., Nappi L; Ob/Gyn Institute, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Jazyk: angličtina
Zdroj: BMC pregnancy and childbirth [BMC Pregnancy Childbirth] 2022 Feb 21; Vol. 22 (1), pp. 142. Date of Electronic Publication: 2022 Feb 21.
DOI: 10.1186/s12884-022-04405-8
Abstrakt: Background: Thrombotic microangiopathy has been invoked as one of the most important mechanisms of damage in COVID-19 patients. Protease ADAMTS13 is a marker of microangiopathy responsible for controlling von Willebrand multimers size. Von Willebrand factor/ADAMTS13 ratio has been found impaired in COVID-19 patients outside pregnancy.
Methods: We prospectively investigated 90 pregnant women admitted to two tertiary academic hospitals in Italy with a laboratory-confirmed diagnosis of SARS-CoV-2 infection. Demographic, clinical information and routine laboratory data were collected at the hospital admission and until discharge. We investigated whether vonWillebrand /ADAMTS13 axis imbalance is a predictor of adverse outcomes. Logistic regression analysis, which controlled for potential confounders, was performed to evaluate the association between laboratory parameters and clinical outcomes.
Results: Most women (55.6%) were parae, with median gestational age at admission of 39 weeks. At hospital admission, 63.3% were asymptomatic for COVID-19 and 24.4% showed more than one sign or symptom of infection. Nulliparae with group O showed Willebrand / ADA MTS-13 ratios significantly lower than non-O, whereas in multiparae this difference was not observed. Logistic regression showed that ratio von Willebrand to ADAMTS13 was significantly and independently associated with preterm delivery (OR 1.9, 95%CI 1.1-3.5).
Conclusion: This study shows an imbalance of vonWillebrand /ADAMTS13 axis in pregnant women with COVID-19, leading to a significantly higher and independent risk of preterm delivery. Monitoring these biomarkers might support decision making process to manage and follow-up pregnancies in this setting.
(© 2022. The Author(s).)
Databáze: MEDLINE
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