Increased risk of pregnancy complications in patients with essential thrombocythemia carrying the JAK2 (617V>F) mutation.
Essential thrombocythemia (ET) may occur in women of childbearing age. To investigate the risk of pregnancy complications, we studied 103 pregnancies that occurred in 62 women with ET. The 2-tailed Fisher exact test showed that pregnancy outcome was independent from that of a previous pregnancy. The rate of live birth was 64%, and 51% of pregnancies were uneventful. Maternal complications occurred in 9%, while fetal complications occurred in 40% of pregnancies. The Mantel-Haenszel method showed that fetal loss in women with ET was 3.4-fold higher (95% confidence interval [CI]: 3-3.9; P < .001) than in the general population. Half of the women studied carried the JAK2 (617V>F) mutation, and a multivariate logistic regression model identified this mutation as an independent predictor of pregnancy complications (P = .01). Neither the platelet count nor the leukocyte count was a risk factor. JAK2 (617V>F)-positive patients had an odds ratio of 2.02 (95% CI: 1.1 - 3.8) of developing complications in comparison with JAK2 (617V>F)-negative patients. Aspirin did not prevent complication in JAK2 (617V>F)-positive patients and appeared to worsen outcome in JAK2 (617V>F)-negative patients. A relationship was found between JAK2 (617V>F) and fetal loss (P = .05). This study indicates that patients carrying the JAK2 (617V>F) mutation have higher risk of developing pregnancy complications.
Passamonti
Francesco
F
Department of Hematology, University of Pavia Medical School, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy. f.passamonti@smatteo.pv.it
Randi
Maria Luigia
ML
Rumi
Elisa
E
Pungolino
Ester
E
Elena
Chiara
C
Pietra
Daniela
D
Scapin
Margherita
M
Arcaini
Luca
L
Tezza
Fabiana
F
Moratti
Remigio
R
Pascutto
Cristiana
C
Fabris
Fabrizio
F
Morra
Enrica
E
Cazzola
Mario
M
Lazzarino
Mario
M
D000293:Adolescent; D000328:Adult; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D005317:Fetal Growth Retardation / Q000097:blood / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology; D053614:Janus Kinase 2 / Q000235:genetics*; D009154:Mutation; D010976:Platelet Count; D011225:Pre-Eclampsia / Q000097:blood / Q000453:epidemiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology; D011252:Pregnancy Complications, Neoplastic / Q000097:blood / Q000453:epidemiology / Q000235:genetics*; D012189:Retrospective Studies; D013920:Thrombocythemia, Essential / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000235:genetics*
C507924:JAK2 protein, human; D053614:Janus Kinase 2