Laboratorio de Hemostasia y Trombosis, Hospital de Infecciosas "Dr. Francisco Javier Muñiz", Buenos Aires, Argentina.
Laboratorio de Hemostasia y Trombosis, Hospital de Infecciosas "Dr. Francisco Javier Muñiz", Buenos Aires, Argentina.
Med Clin (Barc). 2019 Apr 5;152(7):249-254. doi: 10.1016/j.medcli.2017.12.019. Epub 2018 Mar 6.
Thrombophilia might increase the risk of suffering from obstetric complications by adversely affecting the normal placental vascular function. Our aim was to study the distributions of five thrombosis-associated genetic variants: factor V Leiden, prothrombin G20210A, -675 4G/5G PAI-1, 10034C/T gamma fibrinogen and 7872C/T factor XI and the frequencies of the deficiencies of protein C, S and antithrombin in Argentinian patients with recurrent pregnancy loss (RPL) and, therefore, to analyse their association with the risk and timing of RPL and the risk of suffering other vascular obstetric pathologies.
We performed a case-control study that included 247 patients with idiopathic RPL (cases), 107 fertile controls and 224 subjects from general population (reference group). Cases were stratified according to the gestational time of the losses (early RPL, n = 89; late losses, n = 158; foetal losses, n = 107) and according to the type of vascular obstetric pathologies.
No differences were found in the distribution of the genetic variants among RPL group vs. control/reference group (p >.05). Similarly, no differences were observed in their distributions when analysing RPL patients stratified according to gestational times or vascular obstetric pathologies (p >.05), except for the factor V Leiden carriage in patients with foetal growth retardation vs. controls (11.8%, 4/34 vs. 1.9%, 2/107; p = .04) (OR = 7.11 [1.24-40.93], p = .03).
Factor V Leiden might have a significant impact on certain obstetric pathologies such as foetal growth retardation. The genetic variants, 10034C/T gamma fibrinogen and 7872C/T factor XI, associated with thromboembolic disease, would not have an impact on PRE.
血栓形成倾向可能通过对正常胎盘血管功能产生不利影响而增加发生产科并发症的风险。我们的目的是研究五种与血栓形成相关的遗传变异的分布：因子 V 莱顿、凝血酶原 G20210A、-675 4G/5G PAI-1、10034C/T 伽马纤维蛋白原和 7872C/T 因子 XI，以及蛋白 C、S 和抗凝血酶缺乏的频率在阿根廷复发性妊娠丢失（RPL）患者中的分布，并分析它们与 RPL 的风险和时间以及发生其他血管性产科病理的风险的关系。
我们进行了一项病例对照研究，纳入了 247 例特发性 RPL（病例）患者、107 例生育力正常对照者和 224 例一般人群参考组。根据流产的妊娠时间（早期 RPL，n=89；晚期 RPL，n=158；胎儿丢失，n=107）和血管性产科病理类型对病例进行分层。
RPL 组与对照组/参考组之间的遗传变异分布无差异（p>.05）。同样，当根据妊娠时间或血管性产科病理对 RPL 患者进行分层分析时，也未观察到这些分布的差异（p>.05），除了因子 V 莱顿携带在胎儿生长迟缓患者与对照组之间的差异（11.8%，4/34 与 1.9%，2/107；p=0.04）（OR=7.11[1.24-40.93]，p=0.03）。
因子 V 莱顿可能对某些产科病理如胎儿生长迟缓有显著影响。与血栓栓塞性疾病相关的遗传变异 10034C/T 伽马纤维蛋白原和 7872C/T 因子 XI 不会对 PRE 产生影响。
