Relation between maternal thrombophilia and stillbirth according to causes/associated conditions of death

F. Monari, S. Alberico, L. Avagliano, I. Cetin, S. Cozzolino, G. Gargano, L. Marozio, F. Mecacci, I. Neri, A. L. Tranquilli, P. Venturini, F. Facchinetti

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To investigate maternal thrombophilia in cases of Stillbirth (SB), also an uncertain topic because most case series were not characterised for cause/associated conditions of death. Study design: In a consecutive, prospective, multicentre design, maternal DNA was obtained in 171 cases of antenatal SB and 326 controls (uneventful pregnancy at term, 1:2 ratio). Diagnostic work-up of SB included obstetric history, neonatologist inspection, placenta histology, autopsy, microbiology/chromosome evaluations. Results audited in each centre were classified by two of us by using CoDAC. Cases were subdivided into explained SB where a cause of death was identified and although no defined cause was detected in the remnants, 64 cases found conditions associated with placenta-vascular disorders (including preeclampsia, growth restriction and placenta abruption - PVD). In the remnant 79 cases, no cause of death or associated condition was found. Antithrombin activity, Factor V Leiden, G20210A Prothrombin mutation (FII mutation) and acquired thrombophilia were analysed. Results: Overall, the presence of a thrombophilic defect was significantly more prevalent in mothers with SBs compared to controls. In particular, SB mothers showed an increased risk of carrying Factor II mutation (OR = 3.2, 95% CI: 1.3-8.3, p = 0.01), namely in unexplained cases. Such mutation was significantly associated also with previous SB (OR = 8.9, 95%CI 1.2-70.5). At multiple logistic regression, Factor II mutation was the only significantly associated variable with SB (adj OR = 3.8, 95% CI: 1.3-13.5). Conclusion: These data suggest that Factor II mutation is the only condition specifically associated with unexplained SB and could represents a risk of recurrence. PVD-associated condition is unrelated to thrombophilia.

Original languageEnglish
Pages (from-to)251-254
Number of pages4
JournalEarly Human Development
Volume88
Issue number4
DOIs
Publication statusPublished - Apr 2012

Keywords

  • Acquired thrombophilia
  • Factor II mutation
  • Factor V Leiden
  • Placenta vascular disorders
  • Stillbirth

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology

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