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妊娠期高血压疾病风险与凝血因子V莱顿突变的关联:一项荟萃分析。

Association of hypertensive disorders of pregnancy risk and factor V Leiden mutation: A meta-analysis.

作者信息

Li Yuan, Ruan Yan

机构信息

Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.

出版信息

J Obstet Gynaecol Res. 2019 Jul;45(7):1303-1310. doi: 10.1111/jog.13976. Epub 2019 Apr 30.

Abstract

AIM

To date, the conclusions of studies on a possible association between factor V Leiden (FVL, FV G1691A, rs6025) and hypertensive disorders of pregnancy (HDP) are conflicting. Here, we aimed to estimate the relationship between the risk of HDP and FVL.

METHODS

Eligible studies focused on FVL and HDP were searched from the PubMed and the Web of Science databases up to March 31, 2018. We used random effects model for the meta-analysis, and I statistic to assess the degree of heterogeneity between all included studies. To evaluate the association between FVL and the risk of HDP, we calculated the odds ratio (OR) and 95% confidence intervals (CI) comparing cases and controls of all samples and each subgroup based on different regions.

RESULTS

Fifty citations on FVL and HDP were identified through the literature search, and a meta-analysis on the GA + AA genotype between 6041 cases and 8364 controls was conducted. The holistic analysis found that pregnant women with GA or AA genotype of FVL have a 1.97-fold (95% CI: 1.64-2.35, P < 0.00001) increased risk of HDP compared with GG carriers. While the OR are 2.23 (95% CI: 1.76-2.84, P < 0.00001) and 1.90 (95% CI: 1.12-3.23, P = 0.02) in Europe and the Middle East subgroups, respectively.

CONCLUSION

Factor V Leiden mutation is associated with an increased risk of HDP, and is particularly associated with preeclampsia and eclampsia in European women. However, further high-quality studies are warranted to confirm the possible effectiveness of FVL in HDP patients.

摘要

目的

迄今为止,关于凝血因子V莱顿突变(FVL,FV G1691A,rs6025)与妊娠高血压疾病(HDP)之间可能存在关联的研究结论相互矛盾。在此,我们旨在评估HDP风险与FVL之间的关系。

方法

截至2018年3月31日,从PubMed和Web of Science数据库中检索聚焦于FVL和HDP的合格研究。我们使用随机效应模型进行荟萃分析,并使用I统计量评估所有纳入研究之间的异质性程度。为评估FVL与HDP风险之间的关联,我们计算了比值比(OR)和95%置信区间(CI),比较了所有样本以及基于不同地区的每个亚组中的病例和对照。

结果

通过文献检索确定了50篇关于FVL和HDP的文献,并对6041例病例和8364例对照之间的GA + AA基因型进行了荟萃分析。整体分析发现,与GG携带者相比,FVL的GA或AA基因型孕妇发生HDP的风险增加1.97倍(95% CI:1.64 - 2.35,P < 0.00001)。而在欧洲和中东亚组中,OR分别为2.23(95% CI:1.76 - 2.84,P < 0.00001)和1.90(95% CI:1.12 - 3.23,P = 0.02)。

结论

凝血因子V莱顿突变与HDP风险增加相关,尤其与欧洲女性的子痫前期和子痫相关。然而,需要进一步的高质量研究来证实FVL在HDP患者中的可能有效性。

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