Thromb Haemost 2005; 93(06): 1089-1094
DOI: 10.1160/TH04-09-0583
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Elevated factor VII as a risk factor for recurrent fetal loss

Relationship to factor VII gene polymorphisms
Connie H. Miller
1   Division of Hereditary Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
,
Christine De Staercke
1   Division of Hereditary Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
,
Jane Benson
1   Division of Hereditary Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
,
Craig W. Hooper
1   Division of Hereditary Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
,
Anne Dilley*
1   Division of Hereditary Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
,
Bruce L. Evatt
1   Division of Hereditary Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
,
Carlos Benito
2   Division of Maternal-Fetal Medicine, St. Peter’s University Hospital, New Brunswick, New Jersey, USA
,
Anne Patterson-Barnett
3   Northside Women’s Specialists, Atlanta, Georgia, USA
,
Daniel Eller
3   Northside Women’s Specialists, Atlanta, Georgia, USA
,
Claire S. Philipp
4   Division of Hematology, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
› Author Affiliations
Further Information

Publication History

Received 10 September 2004

Accepted after resubmission 09 March 2005

Publication Date:
11 December 2017 (online)

Summary

Haemostatic abnormalities can be detected in a portion of the women who have recurrent fetal loss. We measured factor VII coagulant activity (FVII:C) in 65 women with 3 or more fetal losses (recurrent cases), 31 women with one 2nd or 3rd trimester loss (late loss cases), and 81 women with only live births (controls). FVII:C was greater than 2 standard deviations above the mean for controls in 9 recurrent cases (13.8%) and 2 controls (2.5%) for an odds ratio of 6.35 (95% CI 1.32–30.52, p=0.012). In recurrent cases, mean levels were significantly higher than controls for FVII:C (p=0.003), FVII antigen (p=0.024), and FVIIa (p=0.001). Late loss cases had an odds ratio of 4.23 (95% CI 0.67–26.67, p=0.098) with FVII:C, FVII antigen, and FVIIa not significantly different from the controls. DNA was examined for the presence of mutations or polymorphisms in the promoter region of the FVII gene, using denaturing HPLC. Abnormal patterns were confirmed with direct sequencing. A previously reported polymorphism,–402 G>A, was found to be present in 11/14 subjects with elevated FVII:C (79%) and 43% of those with normal levels (p=0.029). FVII:C, FVII antigen and FVIIa varied significantly with genotype; however, genotype frequencies did not differ between controls and either case group. No other promoter polymorphisms were identified. This is the first report of a significant elevation of FVII in a population with recurrent fetal loss. These data suggest the need for further investigation of this potential risk factor.

* Current address: Worldwide Epidemiology, Glaxo Smith Kline Research & Development.


 
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