Helgadottir Linda B, Skjeldestad Finn E, Jacobsen Anne F, Sandset Per M, Jacobsen Eva-Marie
Department of Haematology, Oslo University Hospital, Ullevål, Oslo, Norway.
Blood Coagul Fibrinolysis. 2011 Dec;22(8):651-6. doi: 10.1097/MBC.0b013e32834a614c.
Inherited thrombophilias are probably associated with placenta-mediated pregnancy complications, but the strength of the association between inherited thrombophilias and intrauterine fetal death after 22 gestational weeks varies due to small sample size and different methodologies used across studies. The objective of the present study was to investigate the association of inherited thrombophilia and intrauterine fetal death in a case-control design. We studied 105 women with a history of intrauterine fetal death after 22 gestational weeks and 262 controls with live births. We investigated the prevalence of the factor V Leiden (F5 rs6025) and prothrombin gene G20210A (F2 rs1799963) polymorphisms, and antithrombin, protein C and protein S deficiencies, and their association with intrauterine fetal death. Results were presented as percentages and odds ratios (ORs) with 95% confidence intervals (CIs). A total of 18.4% of cases and 11.8% of controls were positive for at least one inherited thrombophilia (OR 1.7; 95% CI 0.9-3.1). The prothrombin gene G20210A polymorphism (OR 4.0; 95% CI 1.1-14.4), but not the factor V Leiden polymorphism, or antithrombin, protein C or protein S deficiencies, was associated with intrauterine fetal death after 22 weeks of gestation. Compared with women with live births only, women with a history of intrauterine fetal death after 22 gestational weeks were significantly more often carriers of the prothrombin gene G20210A polymorphism.
遗传性血栓形成倾向可能与胎盘介导的妊娠并发症有关,但由于样本量小以及各研究采用的方法不同,遗传性血栓形成倾向与妊娠22周后宫内胎儿死亡之间关联的强度有所差异。本研究的目的是采用病例对照设计来调查遗传性血栓形成倾向与宫内胎儿死亡之间的关联。我们研究了105例有妊娠22周后宫内胎儿死亡病史的女性以及262例有活产史的对照者。我们调查了凝血因子V莱顿(F5 rs6025)和凝血酶原基因G20210A(F2 rs1799963)多态性的患病率,以及抗凝血酶、蛋白C和蛋白S缺乏症,及其与宫内胎儿死亡的关联。结果以百分比和比值比(OR)及95%置信区间(CI)表示。共有18.4%的病例和11.8%的对照者至少有一种遗传性血栓形成倾向呈阳性(OR 1.7;95% CI 0.9 - 3.1)。凝血酶原基因G20210A多态性(OR 4.0;95% CI 1.1 - 14.4)与妊娠22周后的宫内胎儿死亡有关,而凝血因子V莱顿多态性、抗凝血酶、蛋白C或蛋白S缺乏症则与之无关。与仅有活产史的女性相比,有妊娠22周后宫内胎儿死亡病史的女性更常携带凝血酶原基因G20210A多态性。