Summary

Inherited and acquired thrombophilia are associated withrecurrent pregnancy loss. Recently, an increased risk for thromboembolicdisease was described for patients with elevatedcoagulation factor VIII, but it is unknown whether there is alsoan association to early pregnancy loss. We therefore evaluatedthe relation between recurrent early pregnancy loss and levelsof coagulation factor VIII. We enrolled 49 unrelated Caucasianwomen with a history of 2 - 6 early pregnancy losses and 48healthy controls, who had delivered at least one term infant andhad never experienced pregnancy loss.We determined factor VLeiden-, G20210A prothrombin-, MTHFR C677T- and A1298C-genemutations, levels of antithrombin, protein C, protein S, factorVIII, C-reactive protein and antiphospholipid antibodies. There was a significantly higher rate of pregnancy losses inwomen with Antiphospholipid Syndrome (p = 0.043).Furthermore, plasma levels of coagulation factor VIII were significantlyhigher in cases than in controls (130.5 IU/dl ± 25.4 vs119.5 IU/dl ± 24.1; p = 0.032) and appeared independent of C-reactiveprotein (R = 0.146, p = 0.323 in cases; R = - 0.028, p =0.850 in controls).The relative risk for recurrent pregnancy lossin women with factor VIII levels above 151 IU/dl (90 th percentileof controls) was 2.5 (0.7 – 8.9, 95 percent confidence interval),for levels above 156 IU/dl (95 th percentile of controls) 3.9(0.8 – 20.0, 95 percent confidence interval). Elevated maternalplasma levels of coagulation factor VIII tend to be associatedwith an increased risk for recurrent early pregnancy loss.