Nikolaeva M G, Momot A P, Zainulina M S, Yasafova N N, Taranenko I A
Altai Branch of FSBI "National Research Center for Hematology", Barnaul, Russia.
FSBEI of Higher Education "Altai State Medical University", 40 Lenina Ave, Barnaul, 656038, Russia.
Thromb J. 2021 Jun 5;19(1):41. doi: 10.1186/s12959-021-00289-4.
To study the association between high activity of Factor II (prothrombin) in blood plasma with G20210A mutation and the development of great obstetrical syndromes.
A prospective clinical cohort study was conducted on 290 pregnant women (average age 31.7 ± 4.7 years old). The main group was made up of 140 G20210A patients, while the control group comprised 150 women with the wild G20210G type. The aim was to evaluate the activity of Factor II in the venous blood plasma during the stages of pregnancy with regard to trophoblast invasion waves. As per results, association analysis of Factor II activity value and gestational complications was carried out.
In the control group, the median (Me) of Factor II activity ranged from 108% (preconception period) to 144% (pregnancy) [95% CI 130-150]. In patients with the GA type, the value was significantly higher in related periods, ranging from 149 to 181% [95% CI 142-195], p < 0.0001. With Factor II activity ranging from 148.5 to 180.6%, pregnancies in the main group had no complications. Higher levels of Factor II activity were associated with the development of early and/or severe preeclampsia (PE) and fetal growth retardation (FGR).
The data obtained regarding Factor II activity in blood plasma, juxtaposed with the development of great obstetrical syndromes, allow to assume that manifestation of G20210A in early and/or severe PE and FGR is associated with this coagulation factor's level of activity. Threshold value of the Factor II activity with G20210A mutation, allowing to predict the development of PE, comprised 171.0% at the preconception stage (AUC - 0.86; p < 0.0001) and within 7-8 weeks of gestation it was 181.3% (AUC - 0.84; p < 0.0001).
研究血浆中凝血因子II（凝血酶原）高活性与G20210A突变之间的关联以及严重产科综合征的发生情况。
对290名孕妇（平均年龄31.7±4.7岁）进行了一项前瞻性临床队列研究。主要组由140名G20210A患者组成，而对照组包括150名野生型G20210G女性。目的是评估在妊娠各阶段，随着滋养层侵入波，静脉血浆中凝血因子II的活性。根据结果，对凝血因子II活性值与妊娠并发症进行了关联分析。
在对照组中，凝血因子II活性的中位数（Me）范围从108%（孕前）到144%（孕期）[95%置信区间130 - 150]。在GA型患者中，相关时期该值显著更高，范围为149%至181%[95%置信区间142 - 195]，p < 0.0001。当凝血因子II活性范围为148.5%至180.6%时，主要组的妊娠无并发症。较高水平的凝血因子II活性与早发型和/或重度子痫前期（PE）及胎儿生长受限（FGR）的发生有关。
关于血浆中凝血因子II活性的数据，与严重产科综合征的发生情况并列，使得可以假设G20210A在早发型和/或重度PE及FGR中的表现与该凝血因子的活性水平有关。G20210A突变的凝血因子II活性阈值，在孕前阶段可预测PE的发生，为171.0%（曲线下面积 - 0.86；p < 0.0001），在妊娠7 - 8周内为181.3%（曲线下面积 - 0.84；p < 0.0001）。
