Inherited thrombophilia and preeclampsia within a multicenter cohort: the Montreal Preeclampsia Study

详细信息    查看全文

• 作者：Susan R. Kahn ; Robert Platt ; Helen McNamara ; Rima Rozen ; Moy Fong Chen ; Jacques Genest Jr ; Lise Goulet ; John Lydon ; Louise Seguin ; Clement Dassa ; Andr&#xe9 ; Masse ; Guylaine Asselin ; Alice Benjamin ; Louise Miner ; Antoinette Ghanem ; Michael S. Kramer
• 关键词：factor V Leiden ; folate ; hyperhomocysteinemia ; placental pathology ; preeclampsia ; prothrombin gene mutation
• 刊名：American Journal of Obstetrics and Gynecology
• 出版年：2009
• 出版时间：February 2009
• 年：2009
• 卷：200
• 期：2
• 页码：151.e1-151.e9
• 全文大小：196 K

文摘

Objective

We sought to evaluate the association between inherited thrombophilia and preeclampsia.

Study Design

From a multicenter cohort of 5337 pregnant women, we prospectively identified 113 women who developed preeclampsia and selected 443 control subjects who did not have preeclampsia or nonproteinuric gestational hypertension. Blood samples were tested for DNA polymorphisms affecting thrombophilia (factor V Leiden mutation, prothrombin G20210A mutation, methylenetetrahydrofolate reductase C677T polymorphism), homocysteine, and folate levels, and placentae underwent pathological evaluation.

Results

Thrombophilia was present in 14 % of patients and 21 % of control subjects (adjusted logistic regression odds ratio, 0.6; 95 % confidence interval, 0.3-1.3). Placental underperfusion was present in 63 % of patients vs 46 % of control subjects (P < .001) and was more frequent in women with folate levels in the lowest quartile (P = .04), but was not associated with thrombophilia.

Conclusion

We did not find evidence to support an association between inherited thrombophilia and increased risk of preeclampsia. Placental underperfusion is associated with preeclampsia, but this does not appear to be consequent to thrombophilia.