希腊遗传性血栓形成倾向的遗传及围产期后果

Inheritance and perinatal consequences of inherited thrombophilia in Greece.

作者信息

Karakantza Marina, Androutsopoulos Georgios, Mougiou Athina, Sakellaropoulos Georgios, Kourounis Georgios, Decavalas Georgios

机构信息

Department of Internal Medicine, Division of Hematology, University of Patras Medical School, Patras, Greece.

出版信息

Int J Gynaecol Obstet. 2008 Feb;100(2):124-9. doi: 10.1016/j.ijgo.2007.08.006. Epub 2007 Oct 25.

DOI:10.1016/j.ijgo.2007.08.006

PMID:17963764

Abstract

OBJECTIVE

To investigate the impact of inherited thrombophilic factors on the gestational outcome of unselected pregnant women.

METHOD

A total of 392 women with spontaneous pregnancy were investigated for Factor V Leiden, prothrombin G20210A, and MTHFR C677T mutations. Adverse pregnancy outcomes were recorded.

RESULTS

Thrombophilic genotypes were significantly higher in women with placental abruption. Heterozygocity for Factor V Leiden increased the risk for placental abruption 9.1 times. The MTHFR T677T genotype increased the risk for placental abruption 4.8 times despite folate supplements, and normal serum folate and B(12) levels. Women with inherited thrombophilia and previous obstetric complications were at significant risk for complications in a subsequent pregnancy (P<0.05).

CONCLUSION

Women with placental abruption should be screened for thrombophilic factors and plasma homocysteine should be measured. Subgroups of women with inherited thrombophilia and obstetric complications might benefit from prophylactic anticoagulation in subsequent pregnancies.

摘要

目的

探讨遗传性血栓形成倾向因素对未选择的孕妇妊娠结局的影响。

方法

对392例自然受孕的妇女进行凝血因子V莱顿突变、凝血酶原G20210A突变和亚甲基四氢叶酸还原酶C677T突变检测，并记录不良妊娠结局。

结果

胎盘早剥妇女中血栓形成倾向基因型显著更高。凝血因子V莱顿杂合子使胎盘早剥风险增加9.1倍。尽管补充了叶酸且血清叶酸和维生素B12水平正常，但亚甲基四氢叶酸还原酶T677T基因型仍使胎盘早剥风险增加4.8倍。有遗传性血栓形成倾向且既往有产科并发症的妇女在随后妊娠中发生并发症的风险显著增加（P<0.05）。