凝血因子V Leiden突变与母儿妊娠结局的关系  

The relationship of the factor V Leiden mutation and pregnancy outcomes for mother and fetus

作　　者：Dizon-Townson D. Miller C. Sibai B. 石玉华(译) 

机构地区：[1]Dr. D. Dizon-Townson, University of Utah Health Sciences Center, Department of Obstetrics, 50 North Medical Drive, Salt Lake City, UT 84132, United States [2]不详

出　　处：《世界核心医学期刊文摘（妇产科学分册）》2006年第1期59-60,共2页Core Journal in Obstetrics/Gynecology

摘　　要：We sought to estimate the frequency of pregnancy-related thromboembolic events among carriers of the factor V Leiden (FVL) mutation without a personal history of thromboembolism, and to evaluate the impact of maternal and fetal FVL mutation carriage or other thrombophilias on the risk of adverse outcomes. Methods: Women with a singleton pregnancy and no history of thromboembolism were recruited at 13 clinical centers before 14 weeks of gestation from April 2000 to August 2001. Each was tested for the FVL mutation, as was the resultant conceptus after delivery or after miscarriage, when available. The incidence of thromboembolism (primary outcome), and of other adverse outcomes, was compared between FVL mutation carriers and noncarriers. We also compared adverse outcomes in a secondary nested carrier-control analysis of FVL mutation and other coagulation abnormalities. In this secondary analysis, we defined carriers as women having one or more of the following traits: carrier for FVL mutation, protein C deficiency, protein S deficiency, antithrombin Hl deficiency, activated protein C resistance, or lupus anticoagulant-positive, heterozygous for prothrombin G20210A or homozygous for the 5,10 methylenetetrahydrofolate reductase mutations. Carriers of the FVL mutation alone (with or without activated protein C resistance) were compared with those having one or more other coagulation abnormalities and with controls with no coagulation abnormality. Results: One hundred thirty-four FVL mutation carriers were identified among 4,885 graviclas (2.7% ), with both FVL mutation status and pregnancy outcomes available. No thromboembolic events occurred among the FVL mutation carriers (0% , 95% confidence interval 0- 2.7% ). Three pulmonary emboli and one deep venous thrombosis occurred (0.08% , 95% , confidence interval 0.02- 0.21% ), all occurring in FVL mutation noncarriers. In the nested carrier-control analysis (n = 339), no differences in adverse pregnancy outcomes were observed between FVL mutation carriers, carriers of Objective： We sought to estimate the frequency of pregnancy-related thromboembolic events among carriers of the factor V Leiden （FVL） mutation without a personal history of thromboembolism, and to evaluate the impact of materhal and fetal FVL mutation carriage or other thrombophilias on the risk of adverse outcomes. Methods： Women with a singleton pregnancy and no history of thromboembolism were recruited at 13 clinical centers before 14 weeks of gestation from April 2000 to August 2001. Each was tested for the FVL mutation, as was the resultant conceptus after delivery or after miscarriage, when available. The incidence of thromboembolism （primary outcome）, and of other adverse outcomes, was compared between FVL mutation carriers and noncarriers. We also compared adverse outcomes in a secondary nested carrier-control analysis of FVL mutation and other coagulation abnormalities. In this secondary analysis, we defined carriers as women having one or more of the following traits： carrier for FVL mutation, protein C deficiency, protein S deficiency,

关 键 词：LEIDEN突变 凝血因子V 妊娠结局 亚甲基四氢叶酸还原酶 FVL突变 G20210A 蛋白C抵抗 母儿 血栓栓塞 血栓形成倾向 

分 类 号：R657.34[医药卫生—外科学] R554[医药卫生—临床医学]