Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 180, Issue 4, Pages 335-345Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwu151
Keywords
complications; epidemiology; F5 gene; factor V Leiden; genetics; meta-analysis; severe preeclampsia; systematic review; thrombophilia
Categories
Funding
- National Institutes of Health Research (NIHR) [RP-PG-0609-10181] Funding Source: National Institutes of Health Research (NIHR)
- Medical Research Council [MC_U190081977] Funding Source: Medline
- Department of Health [RP-PG-0609-10181] Funding Source: Medline
- Medical Research Council [MC_U190081977] Funding Source: researchfish
- National Institute for Health Research [ACF-2011-19-011, RP-PG-0609-10181] Funding Source: researchfish
- MRC [MC_U190081977] Funding Source: UKRI
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Severe preeclampsia is a common cause of maternal and perinatal morbidity worldwide. The disease clusters in families; however, individual genetic studies have produced inconsistent results. We conducted a review to examine relationships between maternal genotype and severe preeclampsia. We searched the MEDLINE and Embase databases for prospective and retrospective cohort and case-control studies reporting associations between genes and severe preeclampsia. Four reviewers independently undertook study selection, quality assessment, and data extraction. We performed random-effects meta-analyses by genotype and predefined functional gene group (thrombophilic, vasoactive, metabolic, immune, and cell signalling). Fifty-seven studies evaluated 50 genotypes in 5,049 cases and 16,989 controls. Meta-analysis showed a higher risk of severe preeclampsia with coagulation factor V gene (proaccelerin, labile factor) (F5) polymorphism rs6025 (odds ratio = 1.90, 95% confidence interval: 1.42, 2.54; 23 studies, I-2 = 29%), coagulation factor II (thrombin) gene (F2) mutation G20210A (rs1799963) (odds ratio = 2.01, 95% confidence interval: 1.14, 3.55, 9 studies, I-2 = 0%), leptin receptor gene (LEPR) polymorphism rs1137100 (odds ratio = 1.75, 95% confidence interval: 1.15, 2.65; 2 studies, I-2 = 0%), and the thrombophilic gene group (odds ratio = 1.87, 95% confidence interval: 1.43, 2.45, I-2 = 27%). There were no associations with other gene groups. There was moderate heterogeneity between studies and potential for bias from poor-quality genotyping and inconsistent definition of phenotype. Further studies with robust methods should investigate genetic factors that might potentially be used to stratify pregnancies according to risk of complications.
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