Maternal thrombophilia and the risk of recurrence of preeclampsia.
OBJECTIVE
The aim of this prospective study was to determine the impact of thrombophilia on the recurrence of preeclampsia.


METHODS
In a multicenter, observational, cohort design, 172 white patients with a previous pregnancy complicated by preeclampsia were observed in the next pregnancy. They were evaluated for heritable thrombophilia (factor V Leiden and factor II G20210A mutations, protein S, protein C, and antithrombin deficiency), hyperhomocystinemia, lupus anticoagulant, and anticardiolipin antibodies. Development of preeclampsia and maternal complications and both gestational age at delivery and birthweight were recorded.


RESULTS
Sixty women (34.9%) showed the presence of a thrombophilic defect. They had a higher risk for the recurrence of preeclampsia (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.2-5.1), compared to patients without thrombophilia. Similar findings were observed considering only heritable thrombophilia. Thrombophilic patients were at increased risk for the occurrence of very early preterm delivery (< 32 weeks; OR, 11.6; 95% CI, 3.4-43.2).


CONCLUSIONS
When counseling white women with a history of preeclampsia, screening for thrombophilia can be useful for preconceptional counseling and pregnancy management.
Facchinetti
Fabio
F
Mother-Infant Department, Unit of Gynecology and Obstetrics, Faculty of Medicine and Surgery, University of Modena and Reggio Emilia, Italy. facchi@unimore.it
Marozio
Luca
L
Frusca
Tiziana
T
Grandone
Elvira
E
Venturini
Paolo
P
Tiscia
Giovanni Luca
GL
Zatti
Sonia
S
Benedetto
Chiara
C
D017153:Antibodies, Anticardiolipin / Q000097:blood; D000991:Antithrombins / Q000032:analysis; D001724:Birth Weight; D015331:Cohort Studies; D005165:Factor V / Q000235:genetics; D005260:Female; D005865:Gestational Age; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D011225:Pre-Eclampsia / Q000097:blood* / Q000235:genetics / Q000473:pathology; D011247:Pregnancy; D011446:Prospective Studies; D011486:Protein C / Q000032:analysis; D017293:Protein S / Q000032:analysis; D011516:Prothrombin / Q000235:genetics; D012044:Regression Analysis; D019851:Thrombophilia / Q000150:complications* / Q000235:genetics / Q000473:pathology
D017153:Antibodies, Anticardiolipin; D000991:Antithrombins; D016682:Lupus Coagulation Inhibitor; D011486:Protein C; D017293:Protein S; C095381:factor V Leiden; D006710:Homocysteine; D005165:Factor V; D011516:Prothrombin; D042965:Methylenetetrahydrofolate Reductase (NADPH2)