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Association of Inherited Thrombophilia with Recurrent Pregnancy Loss in Palestinian Women

DOI: 10.1155/2011/689684

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Abstract:

Objective. This study aimed at analyzing the association between recurrent pregnancy loss (RPL) and factor V G1691A (FVL), prothrombin G20210 (FII); and MTHFR C677T (MTHFR) in Palestinian women. Method. We studied 329 Palestinian women with RPL and/or stillbirth (SB); and compared them to 402 healthy reproductive Palestinian women. Cases and controls were tested for the above mutations. Odds ratio (OR) at confidence interval (CI) of 95% was used as a measure of association between the mutations and RPL. Results. Our statistical analysis showed a slightly increased association, which was not significant between FVL and RPL (OR?1.32, 95%?CI?0.90–1.94), and no association between FII (OR?0.84, 95%?CI?0.38–1.92), MTHFR (OR?0.58, 95% CI?0.32–1.03), and RPL. Further analysis of RPL subgroups revealed an association between FVL and first-trimester loss (OR?1.33, 95%?CI?0.892–1.989), and second-trimester loss (OR?1.13, 95%?CI?0.480–2.426), both were not statistically significant. Furthermore, the only statistically significant association was between FVL and SB (OR?2.0, 95%?CI?1.05–3.70). Conclusion. Our analysis had failed to find a significant association between FVL, FII, MTHFR; and RPL in either the first or second trimester. FVL was significantly associated with fetal loss if the loss was a stillbirth. 1. Introduction Molecular studies of coagulation disorders have led to the discovery of an increasing number of mutations in the genes of the factors of coagulation, termed inherited thrombophilia (IT). The most important of this group are factor V gene Leiden mutation G1691A (FVL), prothrombin G20210 (FII), homozygosity for the thermolabile of methyltetrahydrofolate reductase deficiency C677T (MTHFR), antithrombin deficiency, protein C deficiency, and protein S deficiency [1–7]. These conditions affect coagulation cascade at different stages; increasing the potential for thromboembolic diseases (TE) [4, 7]. The importance of IT in obstetrics stems from being partly responsible for up to half of maternal venous TE [2, 5], which is one of the direct leading causes of maternal mortality [2, 5, 8]. While the relationship of IT to TE is not disputed and has been confirmed by a number of studies [4, 7], the evidence is conflicting regarding the association with pregnancy complications [1, 5, 6, 8–11]. A delicate balance between coagulant and anticoagulant factors is needed to achieve a successful pregnancy [12]. A balanced system maintains the blood flow to the feto-maternal exchange unit and promotes trophoblastic proliferation [2, 5, 6]. The hypercoagulable

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