Prothrombin gene G20210A mutation and obstetric complications.
OBJECTIVE
To estimate whether maternal carriage of the prothrombin gene G20210A mutation is associated with pregnancy loss, preeclampsia, placental abruption, or small for gestational age (SGA) neonates in a low-risk, prospective cohort.


METHODS
This was a secondary analysis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development factor V Leiden study, a multicenter, prospective, observational cohort of 5,188 unselected singleton gestations. A total of 4,167 first-trimester samples were available for analysis and were tested for the prothrombin G20210A mutation. Obstetric complications were compared between women with and without the prothrombin G20210A mutation by univariable and multivariable analysis.


RESULTS
A total of 157 (3.8%) women had the prothrombin gene mutation (156 heterozygous and one homozygous). Carriers of the prothrombin G20210A mutation had similar rates of pregnancy loss, preeclampsia, SGA neonates, and abruption compared with noncarriers. Results were similar in a multivariable analysis controlling for age, race, prior pregnancy loss, prior SGA neonates, and family history of thromboembolism. Three thromboembolic events occurred in women testing negative for the mutation.


CONCLUSIONS
There was no association between the prothrombin G20210A mutation and pregnancy loss, preeclampsia, abruption, or SGA neonates in a low-risk, prospective cohort. These data raise questions about the practice of screening women without a history of thrombosis or adverse pregnancy outcomes for this mutation.


METHODS
II.
Silver
Robert M
RM
From the Departments of Obstetrics and Gynecology at the University of Alabama at Birmingham, Birmingham, Alabama; the University of Chicago, Chicago, Illinois; the University of Cincinnati, Cincinnati, Ohio; the University of Pittsburgh, Pittsburgh, Pennsylvania; the University of Miami, Miami, Florida; The Ohio State University, Columbus, Ohio; the University of Tennessee, Memphis, Tennessee; the University of Texas at San Antonio, San Antonio, Texas; the University of Texas Southwestern Medical Center, Dallas, Texas; Thomas Jefferson University, Philadelphia, Pennsylvania; the University of Utah, Salt Lake City, Utah; Wake Forest University Health Sciences, Winston-Salem, North Carolina; and Wayne State University, Detroit, Michigan; the George Washington University Biostatistics Center, Washington, DC, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
Zhao
Yuan
Y
Spong
Catherine Y
CY
Sibai
Baha
B
Wendel
George
G
Wenstrom
Katharine
K
Samuels
Philip
P
Caritis
Steve N
SN
Sorokin
Yoram
Y
Miodovnik
Menachem
M
O'Sullivan
Mary J
MJ
Conway
Deborah
D
Wapner
Ronald J
RJ
D000022:Abortion, Spontaneous / Q000235:genetics; D000037:Abruptio Placentae / Q000235:genetics; D000328:Adult; D005260:Female; D005313:Fetal Death / Q000235:genetics; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011225:Pre-Eclampsia / Q000235:genetics; D011247:Pregnancy; D011248:Pregnancy Complications / Q000235:genetics*; D011250:Pregnancy Complications, Hematologic / Q000235:genetics; D011256:Pregnancy Outcome / Q000235:genetics*; D011446:Prospective Studies; D011516:Prothrombin / Q000235:genetics*; D019851:Thrombophilia / Q000235:genetics*; D055815:Young Adult
D011516:Prothrombin