Soluble thrombomodulin levels among women with a history of recurrent pregnancy loss, with or without antiphospholipid antibodies

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The endothelial cells produce substances whose elevated plasma levels acquire predictive value for the development of events. For instance, soluble thrombomodulin (sTM) levels evidence endothelial cell injury. Under specific clinical conditions the levels of sTM are raised, such as in patients with certain autoimmune disorders, pre-eclampsia or antiphospholipid syndrome. The levels of sTM, as an endothelial injury marker, were evaluated in 65 women with a history of recurrent pregnancy loss (12 with autoimmune disorders, 19 pregnant women and nine with a history of gestational hypertension or pre-eclampsia or eclampsia); 13 of them had antiphospholipid antibodies. sTM levels could be used as a predictor of pregnancy loss in future prospective studies. We compared those levels with the levels found in control groups without recurrent pregnancy loss (20 healthy women and 14 women with autoimmune disorder). There were no statistically significant differences (P = 0.729) in the levels of sTM between the recurrent pregnancy loss group (31.1 ng/ml) and the healthy control group (31.4 ng/ml) or between the different subgroups with recurrent pregnancy loss (P = 0.873) and the healthy control group or the control group with autoimmune disorder (28.0 ng/ml). There were no statistically significant differences (P = 0.605) in the levels of sTM among the patients with recurrent pregnancy loss, with or without moderate or high antiphospholipid antibodies (32.0 versus 23.3 ng/ml). Consequently, the levels of sTM would not seem to be a useful tool, as an endothelial injury marker, in women with a history of recurrent pregnancy loss with or without antiphospholipid antibodies.