Prothrombin 20210 G : A mutation and Factor V Leiden mutation in women with a history of severe preeclampsia and (H)ELLP syndrome

Objective. The 20210 G-A prothrombin gene variant and the Factor V Leiden mutation are mutations associated with venous thrombotic risk. The aim of our study was to assess the prevalence of these specific mutations in women with a history of preeclampsia or hemolysis elevated liver enzymes, and low platelet count [(H)ELLP] syndrome and their influence on perinatal outcome. In addition, the association with venous thromboembolism was assessed. Methods. One hundred fourteen (114) women with a history of preeclampsia or (H)ELLP syndrome were investigated at least 3 months' postpartum for the presence of 20210 G-A prothrombin gene variant and Factor V Leiden mutation. Results. Four (3.5%) of the women had the 20210 G-A prothrombin gene variant, four (3.5%) women had the Factor V Leiden mutation, and one of these women carried both mutations. The prevalence of prothrombin 20210 G-A prothrombin and Factor V Leiden mutation in women with severe preeclampsia or (H)ELLP syndrome were comparable with the prevalence in the general Dutch population. The odds ratio for thromboembolism for carriers versus noncarriers was 22 (95%, confidence interval: 1.7-303). Perinatal mortality was not Significantly higher in women with any mutation [odds ratio: 1.5 (0.2-9.5)]. Conclusions. Although our study confirms that prothrombin 20210 G-A mutation and Factor V Leiden mutation are important genetic risk factors associated with thrombotic risk, these mutations appear not related to perinatal outcome in women with preeclampsia or (H)ELLP syndrome. It is unlikely that these mutations are of major importance for the development of severe preeclampsia or (H)ELLP syndrome.