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Functional and immunologic protein S levels are decreased during pregnancy
PC Comp, GR Thurnau, J Welsh and CT Esmon
Protein S, is a natural anticoagulant protein which serves as a cofactor
for activated protein C. During pregnancy and in the postpartum period,
functional protein S levels are significantly reduced (38% +/- 17.3%, mean
+/- 1 SD) when compared to nonpregnant females (97% +/- 31.6%) (P less than
0.001). In plasma an equilibrium exists between functionally active free
protein S and protein S complexed with C4b-binding protein, which is
functionally inactive. As a result of this equilibrium either a decreased
level of total protein S antigen or an elevation of C4b-binding protein
could lead to reduced protein S activity. C4b-binding protein levels
measured by enzyme- linked immunoassay are not significantly different in
pregnant women versus nonpregnant controls (103.5% +/- 21.2% v 100% +/-
16.9%). However, during pregnancy and in the postpartum period, total
protein S levels are reduced (68% +/- 10.7%) compared to nonpregnant
controls (100% +/- 17.0%). This difference is significant at P less than
0.001. These data demonstrated that the reduction in protein S activity
observed during pregnancy is a result of reduced total protein S antigen.
Volume 68,
Issue 4,
pp. 881-885,
10/01/1986
Copyright © 1986 by The American Society of Hematology
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