Pregnancy complications in G20210A mutation carriers associated with high prothrombin activity

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Genetics

Background:

• Great obstetrical syndromes (GOS) pose significant risks during pregnancy.
• The G20210A mutation in Factor II (prothrombin) is a known thrombophilia risk factor.
• Understanding the role of Factor II activity in GOS is crucial for risk assessment.

Purpose of the Study:

• To investigate the association between elevated Factor II activity, specifically with the G20210A mutation, and the occurrence of GOS.
• To evaluate Factor II activity levels during pregnancy in relation to trophoblast invasion.
• To determine if Factor II activity can serve as a predictive marker for GOS.

Main Methods:

• A prospective clinical cohort study involving 290 pregnant women.
• Comparison of 140 pregnant women with the G20210A mutation (main group) against 150 women with the wild G20210G type (control group).
• Measurement of Factor II activity in venous blood plasma throughout pregnancy and correlation with gestational complications.

Main Results:

• Factor II activity was significantly higher in pregnant women with the G20210A mutation compared to controls (149-181% vs. 108-144%).
• Elevated Factor II activity levels were associated with the development of early and/or severe preeclampsia (PE) and fetal growth restriction (FGR).
• No complications were observed in the main group with Factor II activity between 148.5% and 180.6%.

Conclusions:

• The G20210A mutation's manifestation in PE and FGR is linked to Factor II activity levels.
• A Factor II activity threshold of 171.0% pre-conception and 181.3% at 7-8 weeks gestation can predict PE development in G20210A carriers.
• Factor II activity is a potential biomarker for predicting GOS in women with the G20210A mutation.