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The PAI-1 4G/5G polymorphism is not associated with an increased risk of adverse pregnancy outcome in asymptomatic nulliparous women.
MedLine Citation:
PMID:  22432640     Owner:  NLM     Status:  Publisher    
Background: Plasminogen activator inhibitor type 1 (PAI-1) is an important regulator of fibrinolysis. A common deletion polymorphism which results in a sequence of 4G instead of 5G in the promoter region of the gene is associated with a small increase in the risk of venous thromboembolism. Its potential association with adverse pregnancy events remains controversial. Objective: We aimed to assess the impact of the 4G PAI-1 polymorphism on pregnancy outcomes in women who had no prior history of adverse pregnancy outcomes or personal or family history of venous thromboembolism. Patients / Methods: This study represents a secondary investigation of a prior prospective cohort study investigating the association between inherited thrombophilias and adverse pregnancy events in Australian women. Healthy nulliparous women were recruited to this study prior to 22 weeks gestation. Genotyping for the 4G/5G PAI-1 gene was performed using Taqman assays in an ABI prism 7700 Sequencer several years after the pregnancy was completed. Pregnancy outcome data were extracted from the medical record. The primary outcome was a composite comprising development of severe pre-eclampsia, fetal growth restriction, major placental abruption, stillbirth or neonatal death. Results: Pregnancy outcome data were available in 1733 women who were successfully genotyped for this polymorphism. The primary composite outcome was experienced by 139 women (8% of the cohort). 459 women (26.5%) were homozygous for the 4G deletion polymorphism, while 890 (51.4%) were heterozygous. Neither homozygosity nor heterozygosity for the PAI-1 4G polymorphism was associated with the primary composite outcome (homozygous OR 1.30, 95%CI 0.81-2.09, p=0.28, heterozygous OR 0.84, 95% CI 0.53-1.31, p=0.44) or with the individual pregnancy complications. Conclusion: The PAI-1 4G polymorphism is not associated with an increase in the risk of serious adverse pregnancy events in asymptomatic nulliparous women. © 2012 International Society on Thrombosis and Haemostasis.
Joanne M Said; Franzcog; Ruoxin Tsui; Anthony J Borg; John R Higgins; Mrcog Franzcog; Eric K Moses; Susan P Walker; Paul T Monagle; Shaun P Brennecke
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-16
Journal Detail:
Title:  Journal of thrombosis and haemostasis : JTH     Volume:  -     ISSN:  1538-7836     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101170508     Medline TA:  J Thromb Haemost     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 International Society on Thrombosis and Haemostasis.
Department of Perinatal Medicine, The Royal Women's Hospital, Parkville, Victoria Australia Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia Anu Research Centre, Department of Obstetrics and Gynaecology University College Cork, Ireland. Centre for Genetic Epidemiology and Biostatistics, The University of Western Australia, Australia. Department of Obstetrics and Gynaecology, Mercy Hospital for Women, Heidelberg, Victoria, Australia Department of Haematology, The Royal Children's Hospital, Parkville, Victoria, Australia Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia Murdoch Children's Research Institute, Parkville, Victoria, Australia.
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