title: Relation between maternal thrombophilia and stillbirth according to causes/associated conditions of death.
abstract: OBJECTIVE
  To investigate maternal thrombophilia in cases of Stillbirth (SB), also an uncertain topic because most case series were not characterised for cause/associated conditions of death.
  
  
  METHODS
  In a consecutive, prospective, multicentre design, maternal DNA was obtained in 171 cases of antenatal SB and 326 controls (uneventful pregnancy at term, 1:2 ratio). Diagnostic work-up of SB included obstetric history, neonatologist inspection, placenta histology, autopsy, microbiology/chromosome evaluations. Results audited in each centre were classified by two of us by using CoDAC. Cases were subdivided into explained SB where a cause of death was identified and although no defined cause was detected in the remnants, 64 cases found conditions associated with placenta-vascular disorders (including preeclampsia, growth restriction and placenta abruption - PVD). In the remnant 79 cases, no cause of death or associated condition was found. Antithrombin activity, Factor V Leiden, G20210A Prothrombin mutation (FII mutation) and acquired thrombophilia were analysed.
  
  
  RESULTS
  Overall, the presence of a thrombophilic defect was significantly more prevalent in mothers with SBs compared to controls. In particular, SB mothers showed an increased risk of carrying Factor II mutation (OR=3.2, 95% CI: 1.3-8.3, p=0.01), namely in unexplained cases. Such mutation was significantly associated also with previous SB (OR=8.9, 95%CI 1.2-70.5). At multiple logistic regression, Factor II mutation was the only significantly associated variable with SB (adj OR=3.8, 95% CI: 1.3-13.5).
  
  
  CONCLUSIONS
  These data suggest that Factor II mutation is the only condition specifically associated with unexplained SB and could represents a risk of recurrence. PVD-associated condition is unrelated to thrombophilia.
authors.affiliation: University of Modena and Reggio Emilia, Mother-Infant Dept, Modena, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Monari
authors.forename: S
authors.initials: S
authors.lastname: Alberico
authors.forename: L
authors.initials: L
authors.lastname: Avagliano
authors.forename: I
authors.initials: I
authors.lastname: Cetin
authors.forename: S
authors.initials: S
authors.lastname: Cozzolino
authors.forename: G
authors.initials: G
authors.lastname: Gargano
authors.forename: L
authors.initials: L
authors.lastname: Marozio
authors.forename: F
authors.initials: F
authors.lastname: Mecacci
authors.forename: I
authors.initials: I
authors.lastname: Neri
authors.forename: A L
authors.initials: AL
authors.lastname: Tranquilli
authors.forename: P
authors.initials: P
authors.lastname: Venturini
authors.forename: F
authors.initials: F
authors.lastname: Facchinetti
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002423:Cause of Death; D005260:Female; D005315:Fetal Diseases / Q000401:mortality; D046689:Fetal Mortality; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010922:Placenta Diseases / Q000453:epidemiology / Q000401:mortality; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000401:mortality; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology* / Q000401:mortality; D012959:Socioeconomic Factors; D050497:Stillbirth / Q000453:epidemiology*; D019851:Thrombophilia / Q000150:complications / Q000151:congenital / Q000453:epidemiology* / Q000401:mortality; D055815:Young Adult