HIGH LP(A) LIPOPROTEIN LEVEL IN MATERNAL SERUM MAY INTERFERE WITH PLACENTAL CIRCULATION AND CAUSE FETAL GROWTH-RETARDATION

We report on a woman with an Lp(a) lipoprotein level above the 99th ce ntile of the population distribution of concentrations, who at the age of 43 had had deep vein thrombosis causing a pulmonary embolus and wh ose brother, who also had a very high level, had suffered a cerebral i nfarction at the age of 43. She had given birth to three children, all with very low birth weight, one of whom died when 3 months old. The p lacentas had been small and ischemic. The concurrence of a very high L p(a) lipoprotein level, familial thromboembolic disease and recurrent placental ischemia with delivery of children with low birth weight sug gests the possibility that a very high Lp(a) lipoprotein concentration may predispose to placental insufficiency, presumably arising from pa thological changes in maternal uterine vessels in the placental bed. I f confirmed, a very high Lp(a) lipoprotein level may be a factor to co nsider in women who have repeated pregnancies with placental insuffici ency and who give birth to children with low birth weight.