Inherited thrombophilia and preeclampsia within a multicenter cohort: the Montreal Preeclampsia Study

Kahn, Susan R.; Platt, Robert; McNamara, Helen; Rozen, Rima; Chen, Moy Fong; Genest, Jacques; Goulet, Lise; Lydon, John; Seguin, Louise; Dassa, Clement; Masse, André; Asselin, Guylaine; Benjamin, Alice; Miner, Louise; Ghanem, Antoinette; Kramer, Michael S.

doi:10.1016/j.ajog.2008.09.023

« Previous Next »American Journal of Obstetrics & Gynecology
Volume 200, Issue 2 , Pages 151.e1-151.e9, February 2009

Inherited thrombophilia and preeclampsia within a multicenter cohort: the Montreal Preeclampsia Study

Presented in part at the 27th Annual Meeting of the Society for Maternal–Fetal Medicine, San Francisco, CA, Feb. 6-9, 2007, and in part at the 21st Congress of the International Society on Thrombosis and Hemostasis, Geneva, Switzerland, July 8-12, 2007.

Susan R. Kahn, MD, MSc
- Department of Medicine, McGill University Faculty of Medicine, Montreal, QC, Canada
- Reprints: Susan R. Kahn, MD, MSc, Center for Clinical Epidemiology and Community Studies, Sir Mortimer B. Davis Jewish General Hospital, 3755 Cote Ste. Catherine, Rm. A-127, Montreal, Quebec, Canada H3T 1E2
Robert Platt, PhD
- Department of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, QC, Canada
- Department of Pediatrics, McGill University Faculty of Medicine, Montreal, QC, Canada
Helen McNamara, MD, MSc
- Department of Obstetrics and Gynecology, McGill University Faculty of Medicine, Montreal, QC, Canada
Rima Rozen, MD, PhD
- Department of Pediatrics, McGill University Faculty of Medicine, Montreal, QC, Canada
- Department of Human Genetics, McGill University Faculty of Medicine, Montreal, QC, Canada
Moy Fong Chen, MD
- Department of Pathology, McGill University Faculty of Medicine, Montreal, QC, Canada
Jacques Genest Jr, MD
- Department of Medicine, McGill University Faculty of Medicine, Montreal, QC, Canada
Lise Goulet, MD, PhD
- Département de médecine sociale et préventive, Faculté de médecine, Université de Montréal, Montreal, QC, Canada
- Groupe de recherche interdisciplinaire en santé, Université de Montréal, Montreal, QC, Canada
John Lydon, PhD
- Department of Psychology, McGill University, Montreal, QC, Canada
Louise Seguin, MD, MPH
- Département de médecine sociale et préventive, Faculté de médecine, Université de Montréal, Montreal, QC, Canada
Clement Dassa, PhD
- Département de médecine sociale et préventive, Faculté de médecine, Université de Montréal, Montreal, QC, Canada
André Masse, MD
- Département d'Obstetrique et gynécologie, Université de Montréal, Montreal, QC, Canada
Guylaine Asselin, MD
- Département d'Obstetrique et gynécologie, Université de Montréal, Montreal, QC, Canada
Alice Benjamin, MD
- Department of Obstetrics and Gynecology, McGill University Faculty of Medicine, Montreal, QC, Canada
Louise Miner, MD
- Department of Obstetrics and Gynecology, McGill University Faculty of Medicine, Montreal, QC, Canada
Antoinette Ghanem, RN, MSc
- Groupe de recherche interdisciplinaire en santé, Université de Montréal, Montreal, QC, Canada
Michael S. Kramer, MD
- Department of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, QC, Canada
- Department of Pediatrics, McGill University Faculty of Medicine, Montreal, QC, Canada

Received 18 April 2008; received in revised form 25 July 2008; accepted 22 September 2008. published online 15 December 2008.

Objective

We sought to evaluate the association between inherited thrombophilia and preeclampsia.

Study Design

From a multicenter cohort of 5337 pregnant women, we prospectively identified 113 women who developed preeclampsia and selected 443 control subjects who did not have preeclampsia or nonproteinuric gestational hypertension. Blood samples were tested for DNA polymorphisms affecting thrombophilia (factor V Leiden mutation, prothrombin G20210A mutation, methylenetetrahydrofolate reductase C677T polymorphism), homocysteine, and folate levels, and placentae underwent pathological evaluation.

Results

Thrombophilia was present in 14% of patients and 21% of control subjects (adjusted logistic regression odds ratio, 0.6; 95% confidence interval, 0.3-1.3). Placental underperfusion was present in 63% of patients vs 46% of control subjects (P < .001) and was more frequent in women with folate levels in the lowest quartile (P = .04), but was not associated with thrombophilia.

Conclusion

We did not find evidence to support an association between inherited thrombophilia and increased risk of preeclampsia. Placental underperfusion is associated with preeclampsia, but this does not appear to be consequent to thrombophilia.

Key words: factor V Leiden, folate, hyperhomocysteinemia, placental pathology, preeclampsia, prothrombin gene mutation

Cite this article as: Kahn SR, Platt R, McNamara H, et al. Inherited thrombophilia and preeclampsia within a multicenter cohort: the Montreal Preeclampsia Study. Am J Obstet Gynecol 2009;200:151.e1-151.e9.

Supported by grants from the Canadian Institutes of Health Research (MOP36424) and the March of Dimes Birth Defects Foundation (PERI grant #20-FY04-38). Dr Kahn is a career clinical investigator (chercheur-boursier clinicien) of the Fonds de la recherche en santé du Québec. Dr Platt is a career investigator (chercheur-boursier) of the Fonds de la recherche en santé du Québec. Dr Kramer is a Senior Investigator of the Canadian Institutes of Health Research.

PII: S0002-9378(08)01082-X

doi:10.1016/j.ajog.2008.09.023

Refers to article:

Inherited thrombophilia and preeclampsia: Kahn et al
Christina Scifres, Molly Houser, Sara Nicholas, Dan Czarnecki, Sahar Masoudi, Shayna Norman
American Journal of Obstetrics & Gynecology February 2009 (Vol. 200, Issue 2, Pages 212-213)
Inherited thrombophilia and preeclampsia: is the evidence beginning to congeal?
Edmund F. Funai
American Journal of Obstetrics & Gynecology February 2009 (Vol. 200, Issue 2, Pages 121-122)
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