Lipoprotein (a) and other prothrombotic risk factors in Caucasian women with unexplained recurrent miscarriage. Results of a multicentre case-control study.
From 1998 to 2003, 133 Caucasian women aged 17-40 years (median 29 years) suffering from unexplained recurrent miscarriage (uRM) were consecutively enrolled. In patients and 133 age-matched healthy controls prothrombotic risk factors (factor V (FV) G1691A, factor II (FII) G20210A, MTHFR T677T, 4G/5G plasminogen activator inhibitor (PAI)-1, lipoprotein (Lp) (a), protein C (PC), protein S (PS), antithrombin (AT), antiphospholipid/anticardiolipin (APA/ACA) antibodies) as well as associated environmental conditions (smoking and obesity) were investigated. 70 (52.6%) of the patients had at least one prothrombotic risk factor compared with 26 control women (19.5%; p<0.0001). Body mass index (BMI; p=0.78) and smoking habits (p=0.44) did not differ significantly between the groups investigated. Upon univariate analysis the heterozygous FV mutation, Lp(a) > 30 mg/dL, increased APA/ACA and BMI > 25 kg/m(2) in combination with a prothrombotic risk factor were found to be significantly associated with uRM. In multivariate analysis, increased Lp(a) (odds ratio (OR): 4.7/95% confidence interval (CI): 2.0-10.7), the FV mutation (OR:3.8/CI:1.4-10.7), and increased APA/ACA (OR: 4.5/CI: 1.1-17.7) had independent associations with uRM.
Krause
Manuela
M
Department of Internal Medicine, Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany.
Sonntag
Barbara
B
Klamroth
Robert
R
Heinecke
Achim
A
Scholz
Carola
C
Langer
Claus
C
Scharrer
Inge
I
Greb
Robert R
RR
von Eckardstein
Arnold
A
Nowak-Göttl
Ulrike
U
D000026:Abortion, Habitual / Q000097:blood* / Q000175:diagnosis; D000293:Adolescent; D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000096:biosynthesis; D017152:Antibodies, Antiphospholipid / Q000097:blood; D000925:Anticoagulants / Q000494:pharmacology; D000991:Antithrombins / Q000096:biosynthesis; D015992:Body Mass Index; D016022:Case-Control Studies; D005165:Factor V / Q000096:biosynthesis; D005260:Female; D005500:Follow-Up Studies; D006579:Heterozygote; D006801:Humans; D017270:Lipoprotein(a) / Q000096:biosynthesis / Q000737:chemistry*; D016015:Logistic Models; D045102:Methylenetetrahydrofolate Dehydrogenase (NAD+) / Q000096:biosynthesis; D015999:Multivariate Analysis; D009154:Mutation; D016017:Odds Ratio; D017395:Plasminogen Activator Inhibitor 1 / Q000096:biosynthesis; D011486:Protein C / Q000096:biosynthesis; D017293:Protein S / Q000096:biosynthesis; D011516:Prothrombin / Q000096:biosynthesis; D012307:Risk Factors; D013927:Thrombosis / Q000097:blood* / Q000175:diagnosis
D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D000991:Antithrombins; D017270:Lipoprotein(a); D017395:Plasminogen Activator Inhibitor 1; D011486:Protein C; D017293:Protein S; D005165:Factor V; D011516:Prothrombin; D045102:Methylenetetrahydrofolate Dehydrogenase (NAD+)