Abstract Number: PB1713
Meeting: ISTH 2020 Congress
Background: Significant alterations in platelet activity occur during normal pregnancy and have been linked to placental disorders such as pre-eclampsia and fetal growth restriction (FGR). In recent years aspirin has been advocated to prevent such platelet and placenta mediated complications. Cigarette smoking increases risk of arterial thrombosis through platelet activation and is a leading cause of FGR in pregnancy.
Aims: In this study we examine platelet function in the first trimester of pregnancy in healthy pregnant women, pregnant smokers and non-pregnant controls.
Methods: Following informed consent, blood was obtained from 18 pregnant non-smokers, 15 pregnant smokers and 15 non-smoking volunteers. Platelet aggregation was measured in response to multiple doses of a thrombin-receptor activating peptide (TRAP), collagen related peptide (CRP), and a thromboxane mimic (U46619). In parallel, platelet ATP secretion from dense granules was assessed using a dose range for each agonist, in order to quantify changes in ATP secretion from dense granules.
Results: Significant differences in platelet aggregation are observed at threshold doses of each agonist (TRAP: 9.8uM, CRP: 3.7ug/ml, U46619: 0.9uM) in early pregnancy compared with non-pregnant controls. (figure 1). Platelets from pregnant smokers have significantly higher aggregation to threshold doses of CRP than non-smoking mothers and controls (70.7 ± 6.5%, 45 ± 5.9%, and 6.5 ± 1.2% respectively; P ≤0.0001). Similar patterns are seen with all agonists. In contrast, dense granule secretion is unchanged between subgroups in response to all agonists (figure 2).
Conclusions: Smoking leads to higher levels of platelet aggregation in response to low doses of all agonists, in early pregnancy. This is the first study to demonstrate enhanced platelet activation in pregnant women who smoke. Further work is planned to confirm this trend in middle and late pregnancy and may suggest a role for aspirin in mothers who continue to smoke in pregnancy.
To cite this abstract in AMA style:Cullen S, McDonnell B, Regan C, Moran N. Maternal Platelet Function Altered by Cigarette Smoking in Early Pregnancy [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/maternal-platelet-function-altered-by-cigarette-smoking-in-early-pregnancy/. Accessed December 10, 2023.
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