The role of plasminogen activator inhibitor (PAI-1) in poor obstetric outcome

Abstract

Objective: To assess the role of plasminogen activator inhibitor (PAI-1) in venous thromboembolic disease and placental thromboembolism, which are the main causes of maternal and fetal morbidity and mortality. Methods: This is a study conducted with 144 patients, 70 with a diagnosis of thrombophilia and 74 with low obstetric risk. The presence of PAI-1 and the association of polymorphism – homozygous (4G/4G) or heterozygote (4G/5G) – with poor obstetric outcome were investigated. Results: 52 cases of hereditary thrombophilia (74.29%), 8 cases of acquired thrombophilia (11.43%) and 10 cases of association of hereditary and acquired thrombophilia were identified. PAI-1 was identified in 32 cases (72.73%), 7 of which were homozygous mutants (21.88%) and 25 were heterozygous (78.13%). There was an association of homozygosity with intrauterine fetal death (p=0.003; x²=4.4), preeclampsia (p=0.004; x²-8.03) and Hellp syndrome (p=0.006; x²=7.31). Conclusion: Despite limitations due to sample size, this study was an important step towards identifying the causal link with some poor obstetric outcomes in our population in the SERPINE-1 (PAI-1) gene. To date, our data suggest that homozygosity is associated with fetal death, preeclampsia and Hellp syndrome.