Associations between fetal inherited thrombophilia and adverse pregnancy outcomes.
OBJECTIVE
The purpose of this study was to investigate associations between fetal inherited thrombophilia and adverse pregnancy outcomes, including pregnancy-induced hypertensive disorders (PIHD), antepartum hemorrhage (APH), small-for-gestational age <10th percentile (SGA), and preterm birth (PTB).


METHODS
Seven hundred and seventeen cases and 609 controls were genotyped for Factor V Leiden (FVL, G1691A), Prothrombin gene mutation (PGM, G20210A), and Methylenetetrahydrofolate reductase (MTHFR) C677T and MTHFR A1298C using DNA from newborn screening cards.


RESULTS
For babies born <28 weeks' gestation, PGM was associated with an increased risk of SGA (OR 6.40, 95%CI 1.66-24.71) and APH with SGA (OR 6.35, 95%CI 1.63-24.75). Homozygous MTHFR A1298C was associated with an increased risk of SGA for babies born 28-31 weeks gestation (OR 4.00, 95%CI 1.04-15.37), and with APH and SGA for babies born <32 weeks' gestation (OR 3.57, 95%CI 1.09-11.66). Homozygous MTHFR C677T was associated with a reduced risk of PTB and SGA (OR 0.52, 95%CI 0.28-0.96) for babies born 32 to 36 weeks' gestation. Homozygous FVL decreased the risk of PTB <32 weeks' gestation (OR 0.55, 95%CI 0.31-0.98).


CONCLUSIONS
Fetal thrombophilic polymorphisms may be related to adverse pregnancy outcomes, in particular SGA.
Department of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, South Australia. catherine.s.gibson@adelaide.edu.au
Catherine S
CS
Gibson
Alastair H
AH
MacLennan
Nard G
NG
Janssen
Willem J
WJ
Kist
William M
WM
Hague
Eric A
EA
Haan
Paul N
PN
Goldwater
Kevin
K
Priest
Gustaaf A
GA
Dekker
D016022:Case-Control Studies; D005260:Female; D005315:Fetal Diseases / Q000235:genetics*; D006470:Hemorrhage / Q000453:epidemiology; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D019851:Thrombophilia / Q000235:genetics*