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Trastornos trombofílicos y pérdida fetal: un metanálisis
Evelyne Rey1, Susan R Kahn, Michèle David
1Department of Obstetrics and Gynecology, Sainte-Justine Hospital, Quebec, Montreal, Canada. evelyne_rey@ssss.gouv.qc.ca
Lancet (London, England)
|March 22, 2003
Resumen
La trombofilia, un trastorno de la coagulación sanguínea, está relacionada con la pérdida fetal recurrente y no recurrente, con la fuerza de esta asociación que varía según el tipo de trombofilia y el momento de la pérdida fetal.
Área de la Ciencia:
- La Medicina Reproductiva es una de ellas.
- Hematología Hematología.
- Genética La genética.
Sus antecedentes:
- La trombofilia es un controvertido factor de riesgo para la pérdida fetal.
- La fuerza de la asociación puede depender del momento y la definición de la pérdida fetal.
Objetivo del estudio:
- Para evaluar la asociación entre la trombofilia y la pérdida fetal.
- Para determinar si esta asociación varía según el momento o la definición de pérdida fetal.
Principales métodos:
- Un metanálisis de 31 estudios (caso-control, cohorte, transversal) publicados entre 1975 y 2002.
- Buscado Medline y contenidos actuales para la literatura relevante.
- Las proporciones de probabilidades agrupadas (OR) se generaron utilizando modelos de efectos aleatorios.
Principales resultados:
- La mutación del Factor V de Leiden se asoció con la pérdida fetal recurrente temprana y tardía, y la pérdida fetal no recurrente tardía.
- La resistencia a la proteína C activada, la mutación de la protrombina G20210A y la deficiencia de proteína S mostraron asociaciones significativas con varios tipos de pérdida fetal.
- La mutación del metilenetetrahidrofolato, la proteína C y las deficiencias de antitrombina no se asociaron significativamente con la pérdida fetal.
Conclusiones:
- Se confirma la asociación entre la trombofilia y la pérdida fetal.
- La fuerza de esta asociación varía significativamente en función de la trombofilia específica y el tipo / momento de la pérdida fetal.
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