Document Detail

Hyperhomocysteinemia and other thrombotic risk factors in women with placental vasculopathy.
MedLine Citation:
PMID:  10847236     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate coagulation inhibitors and abnormalities of the homocysteine metabolism, which are related to an increased thrombotic risk, as risk factors for placental vasculopathy. DESIGN: A case-control study comparing nonpregnant women with an obstetric history of placental vasculopathy (study group) with nonpregnant women (control group) matched for age and occupation. SETTING: Obstetric outpatient clinic in the University Hospital Nijmegen. SAMPLE: One hundred and one women in the study group and 92 women in a control group. METHODS: Determinations in blood samples of homocysteine concentrations; the occurrence of 677 C-->T mutation in the methylenetetrahydrofolate reductase (MTHFR) gene; protein C activities; activated protein C resistance ratios; concentrations of free protein S antigen; antithrombin III activities; and the occurrence of factor V Leiden mutation. RESULTS: Increased risk for placental vasculopathy was found in the study group with elevated homocysteine (odds ratio 2.28, 95% CI 1.18-4.39), MTHFR mutation (odds ratio 3.29, 95% CI 1.03-10.5), decreased activated protein C resistance ratio (odds ratio 2.46, 95% CI 1.06-5.72) and protein C (odds ratio 2.01, 95% CI 1.11-3.65). Any combination of two risk factors in the same individual resulted in a 3.40 (95% CI 1.80-6.42) higher relative risk for placental vasculopathy; combinations of three risk factors in a 6.83 (95% CI 1.52-30.7) higher risk. CONCLUSIONS: The thrombotic risk factors decreased levels of activated protein C resistance ratios and protein C, elevated homocysteine and the MTHFR 677 C-->T mutation are likely risk factors for placental vasculopathy. Combinations of these risk factors in one individual resulted in synergistic increase of risk.
E F van der Molen; B Verbruggen; I Nováková; T K Eskes; L A Monnens; H J Blom
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  107     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-07-03     Completed Date:  2000-07-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  785-91     Citation Subset:  AIM; IM    
Department of Paediatrics, Nijmegen University Hospital, The Netherlands.
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MeSH Terms
Activated Protein C Resistance / blood,  etiology
Antithrombin III / metabolism
Case-Control Studies
Factor V / genetics
Homocysteine / blood
Hyperhomocysteinemia / complications*
Mutation / genetics
Placenta / blood supply
Placenta Diseases / etiology*
Protein C / metabolism
Protein S / metabolism
Risk Factors
Tetrahydrofolates / blood
Thrombosis / etiology*
Reg. No./Substance:
0/Protein C; 0/Protein S; 0/Tetrahydrofolates; 0/factor V Leiden; 454-28-4/Homocysteine; 9000-94-6/Antithrombin III; 9001-24-5/Factor V

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