Inherited risk of thrombosis of the fetus and intrauterine fetal death.
OBJECTIVE
To test the hypothesis that abnormal placentation resulting in intrauterine fetal death (IUFD) is associated with coagulation abnormalities in the fetus.


METHODS
We analyzed fetal DNA from umbilical cords from 139 pregnancies complicated by intrauterine fetal death during 1994-1998 (cases). Fetal DNA was tested for the presence of factor V Leiden and prothrombin G20210A mutations. The prevalence of these thrombophilic mutations among cases were compared with the prevalence in a historic control group.


RESULTS
Overall, a higher prevalence of fetal genetic risk factors was found in cases (9.8%) as compared to fetuses born from an uncomplicated pregnancy (2%, odds ratio 4.8, 95% CI 1.1-22). Second trimester intrauterine fetal death occurred more frequently in cases with the factor V Leiden mutation as compared with the control group (8/64 versus 0/92). For intrauterine fetal death and factor V Leiden a high risk was found concerning abruption placentae (odds ratio 7.6, 95% CI 1.5-37).


CONCLUSIONS
The prevalence of fetal genetic risk factors associated with an increased risk for thrombosis was higher in pregnancies complicated by intrauterine fetal death suggesting an important role of abnormal coagulation in placentation.
Dekker
Jan Willem T
JW
Departments of Obstetrics and Gynecology, Westeinde Hospital, The Hague, The Netherlands.
Lind
Jan
J
Bloemenkamp
Kitty W M
KW
Quint
Wim G V
WG
Kuijpers
Johan C
JC
van Doorn
Leen-Jan
LJ
de Groot
Christianne J M
CJ
D016022:Case-Control Studies; D005165:Factor V / Q000235:genetics*; D005260:Female; D005313:Fetal Death / Q000453:epidemiology / Q000235:genetics*; D006801:Humans; D007020:Hypoprothrombinemias / Q000235:genetics*; D016017:Odds Ratio; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology*; D011262:Pregnancy Trimester, Second; D015995:Prevalence; D019851:Thrombophilia / Q000150:complications / Q000453:epidemiology / Q000235:genetics*; D013927:Thrombosis / Q000453:epidemiology / Q000235:genetics*
C095381:factor V Leiden; D005165:Factor V