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(Hypertension. 2005;46:1270.)
© 2005 American Heart Association, Inc.

Original Articles

Thrombophilia Is Significantly Associated With Severe Preeclampsia

Results of a Large-Scale, Case-Controlled Study

Giorgio Mello; Elena Parretti; Luca Marozio; Cristina Pizzi; Andrea Lojacono; Tiziana Frusca; Fabio Facchinetti; Chiara Benedetto

From the Maternal–Fetal Medicine High-Risk Pregnancies Unit (G.M., E.P.), University of Florence, Italy; Department of Obstetrics and Gynecology (L.M., C.B.), University of Turin, Italy; Mother–Infant Department (C.P., F.F.), Unit of Gynecology and Obstetrics, University of Modena and Reggio Emilia, Italy; and Department of Obstetrics and Gynecology (A.L., T.F.), University of Brescia, Italy.

Correspondence to Chiara Benedetto, Via Ventimiglia 3, 10125 Torino, Italy. E-mail chbened{at}tin.it

The role of thrombophilia in the pathogenesis of preeclampsia is controversial. The aim of this case-controlled study was to determine whether thrombophilia increases the risk of preeclampsia or interferes with its clinical course. A total of 808 white patients who developed preeclampsia (cases) and 808 women with previous uneventful pregnancies (controls) matched for age and parity were evaluated for inherited and acquired thrombophilia (factor V Leiden; factor II G20210A; methylenetetrahydrofolate reductase C677T; protein S, protein C, and antithrombin III deficiency; anticardiolipin antibodies; lupus anticoagulant; and hyperhomocysteinemia). Odds ratios (ORs) with 95% confidence intervals (CIs) for risk of being carriers of thrombophilia in cases compared with controls and for risk of maternal life-threatening complications and adverse perinatal outcomes in preeclamptic patients with or without thrombophilia were calculated. Women with severe preeclampsia (406 cases) had a higher risk (OR, 4.9; 95% CI, 3.5 to 6.9) of being carriers of either an inherited or acquired thrombophilic factor, except for protein S, protein C, and antithrombin deficiency. In women with mild preeclampsia (402 cases), only prothrombin and homozygous methylenetetrahydrofolate reductase gene mutations were significantly more prevalent than in the controls. Thrombophilic patients with severe preeclampsia are at increased risk of acute renal failure (OR, 1.8; 95% CI, 1.5 to 2.2), disseminated intravascular coagulation (OR, 2.7; 95% CI, 1.1 to 6.4), abruptio placentae (OR, 2.6; 95% CI, 1.2 to 6.0) and perinatal mortality (OR, 1.7; 95% CI, 1.5 to 2.2) compared with nonthrombophilic preeclamptic patients. Our study demonstrates a significant association between maternal thrombophilia and severe preeclampsia in white women. Thrombophilia also augments the risk of life-threatening maternal complications and adverse perinatal outcomes in preeclamptic patients.

Key Words: preeclampsia • thrombophilia • maternal outcome • perinatal outcome

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