comparison of activated protein c resistance in pregnant women who smoke and do not smoke

Activated protein C (APC) proteolyticly inactivates the factor Va and factor Vllla, which acts as a cofactor in the process, during coagulation; restricts the coagulant role. Resistance to APC, which develops for any reason, poses a significant risk for venous thrombosis. In most cases, the development of APC resistance is due to a spot mutation in the factor V gene. This mutation is called factor V (1691 G➔A) Leiden mutation and is especially common in European countries. Some studies have shown that acquired resistance to the activated protein C is a normal finding of pregnancy. In these studies, APC resistance and factor V Leiden mutations were not detected in pregnant women. The importance of resistance to the activated protein C seen in cases where factor V Leiden mutation has not been detected has not yet been determined. For this purpose, in this study; we aimed to examine how a number of hemostatic parameters vary during pregnancy among smokers and non-smokers; how this change is reflected in APC sensitivity rates or whether smoking will affect these hemostatic parameters as a direct or indirect factor knowing that there are significant changes in the hemostatic system in pregnancy. A total of 80 healthy pregnant women, including 42 nonsmokers and 38 non-smokers, completed our study. As a result: 1. The rate of APC sensitivity decreases later in pregnancy. This change appears to be an acquired condition brought about by pregnancy. 2. During the course of pregnancy, the rate of APC sensitivity is more affected in pregnant women who smoke than in non-smokers. 3. The change in coagulation factors in the course of pregnancy is compatible with the current literature in non-smoking pregnant women. In pregnant women who smoke, the change in coagulation factors is different. 4. In the smoking group, further studies are needed at the molecular level in order to understand the clinical importance of this different course seen in hemostatic parameters, although it is shown in our study, and to clarify the underlying mechanisms.