Prothrombin gene G20210A mutation and obstetric complications

Robert M. Silver, Yuan Zhao, Catherine Y. Spong, Baha Sibai, George Wendel, Katharine Wenstrom, Philip Samuels, Steve N. Caritis, Yoram Sorokin, Menachem Miodovnik, Mary J. O'Sullivan, Deborah Conway, Ronald J. Wapner

Research output: Contribution to journalArticle

100 Scopus citations

Abstract

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. CONCLUSION: 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.

Original languageEnglish (US)
Pages (from-to)14-20
Number of pages7
JournalObstetrics and gynecology
Volume115
Issue number1
DOIs
StatePublished - Jan 2010

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Silver, R. M., Zhao, Y., Spong, C. Y., Sibai, B., Wendel, G., Wenstrom, K., Samuels, P., Caritis, S. N., Sorokin, Y., Miodovnik, M., O'Sullivan, M. J., Conway, D., & Wapner, R. J. (2010). Prothrombin gene G20210A mutation and obstetric complications. Obstetrics and gynecology, 115(1), 14-20. https://doi.org/10.1097/AOG.0b013e3181c88918