Background Previous data have demonstrated associations betweenthrombophilia polymorphisms in pregnant women and an increasedrisk of intrauterine growth restriction in their offspring,but this finding remains uncertain.
Methods We performed a hospital-based case–control studyand a family-based study including 493 newborns with intrauterinegrowth restriction (defined by birth weight below the 10th percentilefor gestational age and sex according to Canadian norms) and472 controls (with birth weight at or above the 10th percentile).We determined the presence or absence in newborns and theirparents of the following polymorphisms: methylenetetrahydrofolatereductase (MTHFR) C677T and A1298C, factor V Leiden G1691A,and prothrombin G20210A. Mothers were interviewed to obtaininformation on other risk factors for intrauterine growth restriction.
Results The risk of intrauterine growth restriction was notincreased among mothers carrying a polymorphism associated withthrombophilia. In the case–control study, the odds ratiosassociated with two copies of the variant, after adjustmentfor newborn genotype and other risk factors, were 1.55 for MTHFRC677T (95 percent confidence interval, 0.83 to 2.90) and 0.49for MTHFR A1298C (95 percent confidence interval, 0.25 to 0.93);heterozygotes for factor V Leiden had an odds ratio of 1.18(95 percent confidence interval, 0.54 to 2.55), and heterozygotesfor prothrombin G20210A had an odds ratio of 0.92 (95 percentconfidence interval, 0.36 to 2.35). These polymorphisms in thenewborn were not associated with an increased risk. Newbornswho were homozygous for the MTHFR C677T variant had a decreasedrisk of intrauterine growth restriction (odds ratio after adjustmentfor mother's genotype and other confounders, 0.52 [95 percentconfidence interval, 0.29 to 0.94]). The results of the family-basedstudy supported those of the case–control study.
Conclusions Our findings do not indicate that there are associationsbetween maternal or newborn polymorphisms associated with thrombophiliaand an increased risk of intrauterine growth restriction.
Source Information
From the Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal (C.I.-R.); the Research Centre (C.I.-R., G.-E.R., W.V.Y., J.C.F.-F.), the Division of Hematology and Oncology (G.E.-R., W.V.Y.), and the Department of Obstetrics (R.G.), Centre Hospitalier Universitaire Mère–Enfant, Hôpital Sainte-Justine, Université de Montréal, Montreal; INSERM Unité 535, Génétique Epidémiologique et Structure des Populations Humaines, Le Kremlin Bicêtre, Paris (E.G., M.G.); and the National Institute of Environmental Health Sciences, Research Triangle Park, N.C. (C.W.).
Address reprint requests to Dr. Infante-Rivard at the Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, 1130 Pine Ave. W., Montreal, QC H3A 1A3, Canada, or at claire.infante-rivard{at}mcgill.ca.
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