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

Title: Obstetric outcomes in pregnant COVID-19 women: the imbalance of von Willebrand factor and ADAMTS13 axis
Authors: Grandone E.; Vimercati A.; Sorrentino F.; Colaizzo D.; Ostuni A.; Ceci O.; Capozza M.; Tiscia G.; De Laurenzo A.; Mastroianno M.; Cappucci F.; Fischetti L.; Margaglione M.; Cicinelli E.; Nappi L.
Contributors: Grandone, E.; Vimercati, A.; Sorrentino, F.; Colaizzo, D.; Ostuni, A.; Ceci, O.; Capozza, M.; Tiscia, G.; De Laurenzo, A.; Mastroianno, M.; Cappucci, F.; Fischetti, L.; Margaglione, M.; Cicinelli, E.; Nappi, L.
Publication Year: 2022
Collection: Università degli Studi di Bari Aldo Moro: CINECA IRIS
Subject Terms: AB0 blood group system; ADAMTS13; COVID-19; Pregnancy; von Willebrand factor; ADAMTS13 Protein; Academic Medical Center; Adolescent; Adult; Biomarker; Female; Human; Italy; Middle Aged; Pregnancy Complication; Premature Birth; SARS-CoV-2; Tertiary Care Center; Thrombotic Microangiopathie; Young Adult
Description: 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: Mostwomen (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.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/35189860; info:eu-repo/semantics/altIdentifier/wos/WOS:000758811100001; volume:22; issue:1; firstpage:142; numberofpages:9; journal:BMC PREGNANCY AND CHILDBIRTH; https://hdl.handle.net/11586/391438
DOI: 10.1186/s12884-022-04405-8
Availability: https://hdl.handle.net/11586/391438; https://doi.org/10.1186/s12884-022-04405-8; https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-022-04405-8
Rights: info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.9FE591D5
Database: BASE