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The PAI‐1 4G/5G polymorphism is not associated with an increased risk of adverse pregnancy outcome in asymptomatic nulliparous women

Background:  Plasminogen activator inhibitor type 1 (PAI‐1) is an important regulator of fibrinolysis. A common deletion polymorphism that results in a sequence of 4G instead of 5G in the promoter region of the gene is associated with a small increase in the risk of venous thromboembolism. Its poten...

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Published in:Journal of thrombosis and haemostasis 2012-05, Vol.10 (5), p.881-886
Main Authors: SAID, J. M., TSUI, R., BORG, A. J., HIGGINS, J. R., MOSES, E. K., WALKER, S. P., MONAGLE, P. T., BRENNECKE, S. P.
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creator SAID, J. M.
TSUI, R.
BORG, A. J.
HIGGINS, J. R.
MOSES, E. K.
WALKER, S. P.
MONAGLE, P. T.
BRENNECKE, S. P.
description Background:  Plasminogen activator inhibitor type 1 (PAI‐1) is an important regulator of fibrinolysis. A common deletion polymorphism that results in a sequence of 4G instead of 5G in the promoter region of the gene is associated with a small increase in the risk of venous thromboembolism. Its potential association with adverse pregnancy events remains controversial. Objective:  We aimed to assess the impact of the 4G PAI‐1 polymorphism on pregnancy outcomes in women who had no prior history of adverse pregnancy outcomes or personal or family history of venous thromboembolism. Patients/methods:  This study represents a secondary investigation of a prior prospective cohort study investigating the association between inherited thrombophilias and adverse pregnancy events in Australian women. Healthy nulliparous women were recruited to this study prior to 22 weeks gestation. Genotyping for the 4G/5G PAI‐1 gene was performed using Taqman assays in an ABI prism 7700 Sequencer several years after the pregnancy was completed. Pregnancy outcome data were extracted from the medical record. The primary outcome was a composite comprising development of severe pre‐eclampsia, fetal growth restriction, major placental abruption, stillbirth or neonatal death. Results:  Pregnancy outcome data were available in 1733 women who were successfully genotyped for this polymorphism. The primary composite outcome was experienced by 139 women (8% of the cohort). Four hundred and fifty‐nine women (26.5%) were homozygous for the 4G deletion polymorphism, while 890 (51.4%) were heterozygous. Neither homozygosity nor heterozygosity for the PAI‐1 4G polymorphism was associated with the primary composite outcome (homozygous OR = 1.30, 95% CI = 0.81–2.09, P = 0.28, heterozygous OR = 0.84, 95% CI = 0.53–1.31, P = 0.44) or with the individual pregnancy complications. Conclusion:  The PAI‐1 4G polymorphism is not associated with an increase in the risk of serious adverse pregnancy events in asymptomatic nulliparous women.
doi_str_mv 10.1111/j.1538-7836.2012.04700.x
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M. ; TSUI, R. ; BORG, A. J. ; HIGGINS, J. R. ; MOSES, E. K. ; WALKER, S. P. ; MONAGLE, P. T. ; BRENNECKE, S. P.</creator><creatorcontrib>SAID, J. M. ; TSUI, R. ; BORG, A. J. ; HIGGINS, J. R. ; MOSES, E. K. ; WALKER, S. P. ; MONAGLE, P. T. ; BRENNECKE, S. P.</creatorcontrib><description>Background:  Plasminogen activator inhibitor type 1 (PAI‐1) is an important regulator of fibrinolysis. A common deletion polymorphism that results in a sequence of 4G instead of 5G in the promoter region of the gene is associated with a small increase in the risk of venous thromboembolism. Its potential association with adverse pregnancy events remains controversial. Objective:  We aimed to assess the impact of the 4G PAI‐1 polymorphism on pregnancy outcomes in women who had no prior history of adverse pregnancy outcomes or personal or family history of venous thromboembolism. Patients/methods:  This study represents a secondary investigation of a prior prospective cohort study investigating the association between inherited thrombophilias and adverse pregnancy events in Australian women. Healthy nulliparous women were recruited to this study prior to 22 weeks gestation. Genotyping for the 4G/5G PAI‐1 gene was performed using Taqman assays in an ABI prism 7700 Sequencer several years after the pregnancy was completed. Pregnancy outcome data were extracted from the medical record. The primary outcome was a composite comprising development of severe pre‐eclampsia, fetal growth restriction, major placental abruption, stillbirth or neonatal death. Results:  Pregnancy outcome data were available in 1733 women who were successfully genotyped for this polymorphism. The primary composite outcome was experienced by 139 women (8% of the cohort). Four hundred and fifty‐nine women (26.5%) were homozygous for the 4G deletion polymorphism, while 890 (51.4%) were heterozygous. Neither homozygosity nor heterozygosity for the PAI‐1 4G polymorphism was associated with the primary composite outcome (homozygous OR = 1.30, 95% CI = 0.81–2.09, P = 0.28, heterozygous OR = 0.84, 95% CI = 0.53–1.31, P = 0.44) or with the individual pregnancy complications. Conclusion:  The PAI‐1 4G polymorphism is not associated with an increase in the risk of serious adverse pregnancy events in asymptomatic nulliparous women.</description><identifier>ISSN: 1538-7933</identifier><identifier>ISSN: 1538-7836</identifier><identifier>EISSN: 1538-7836</identifier><identifier>DOI: 10.1111/j.1538-7836.2012.04700.x</identifier><identifier>PMID: 22432640</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Abruptio Placentae - blood ; Abruptio Placentae - genetics ; Adult ; Asymptomatic Diseases ; cohort study ; Female ; Fetal Death - blood ; Fetal Death - genetics ; Fetal Growth Retardation - blood ; Fetal Growth Retardation - genetics ; Fibrinolysis - genetics ; Genetic Predisposition to Disease ; Gestational Age ; Heterozygote ; Homozygote ; Humans ; Logistic Models ; nulliparous ; Odds Ratio ; PAI‐1 ; Parity ; Phenotype ; Plasminogen Activator Inhibitor 1 - genetics ; Polymorphism, Genetic ; Pre-Eclampsia - blood ; Pre-Eclampsia - genetics ; Pregnancy ; Pregnancy Complications - blood ; Pregnancy Complications - genetics ; Pregnancy Outcome ; pre‐eclampsia ; Prospective Studies ; Risk Assessment ; Risk Factors ; Stillbirth - genetics ; thrombophilia ; Victoria</subject><ispartof>Journal of thrombosis and haemostasis, 2012-05, Vol.10 (5), p.881-886</ispartof><rights>2012 International Society on Thrombosis and Haemostasis</rights><rights>2012 International Society on Thrombosis and Haemostasis.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4190-3d01a84174c1e804ea5c58765609bd484c15f11b04026435d1f579fe907b17563</citedby><cites>FETCH-LOGICAL-c4190-3d01a84174c1e804ea5c58765609bd484c15f11b04026435d1f579fe907b17563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22432640$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SAID, J. M.</creatorcontrib><creatorcontrib>TSUI, R.</creatorcontrib><creatorcontrib>BORG, A. J.</creatorcontrib><creatorcontrib>HIGGINS, J. R.</creatorcontrib><creatorcontrib>MOSES, E. K.</creatorcontrib><creatorcontrib>WALKER, S. P.</creatorcontrib><creatorcontrib>MONAGLE, P. T.</creatorcontrib><creatorcontrib>BRENNECKE, S. P.</creatorcontrib><title>The PAI‐1 4G/5G polymorphism is not associated with an increased risk of adverse pregnancy outcome in asymptomatic nulliparous women</title><title>Journal of thrombosis and haemostasis</title><addtitle>J Thromb Haemost</addtitle><description>Background:  Plasminogen activator inhibitor type 1 (PAI‐1) is an important regulator of fibrinolysis. A common deletion polymorphism that results in a sequence of 4G instead of 5G in the promoter region of the gene is associated with a small increase in the risk of venous thromboembolism. Its potential association with adverse pregnancy events remains controversial. Objective:  We aimed to assess the impact of the 4G PAI‐1 polymorphism on pregnancy outcomes in women who had no prior history of adverse pregnancy outcomes or personal or family history of venous thromboembolism. Patients/methods:  This study represents a secondary investigation of a prior prospective cohort study investigating the association between inherited thrombophilias and adverse pregnancy events in Australian women. Healthy nulliparous women were recruited to this study prior to 22 weeks gestation. Genotyping for the 4G/5G PAI‐1 gene was performed using Taqman assays in an ABI prism 7700 Sequencer several years after the pregnancy was completed. Pregnancy outcome data were extracted from the medical record. The primary outcome was a composite comprising development of severe pre‐eclampsia, fetal growth restriction, major placental abruption, stillbirth or neonatal death. Results:  Pregnancy outcome data were available in 1733 women who were successfully genotyped for this polymorphism. The primary composite outcome was experienced by 139 women (8% of the cohort). Four hundred and fifty‐nine women (26.5%) were homozygous for the 4G deletion polymorphism, while 890 (51.4%) were heterozygous. Neither homozygosity nor heterozygosity for the PAI‐1 4G polymorphism was associated with the primary composite outcome (homozygous OR = 1.30, 95% CI = 0.81–2.09, P = 0.28, heterozygous OR = 0.84, 95% CI = 0.53–1.31, P = 0.44) or with the individual pregnancy complications. Conclusion:  The PAI‐1 4G polymorphism is not associated with an increase in the risk of serious adverse pregnancy events in asymptomatic nulliparous women.</description><subject>Abruptio Placentae - blood</subject><subject>Abruptio Placentae - genetics</subject><subject>Adult</subject><subject>Asymptomatic Diseases</subject><subject>cohort study</subject><subject>Female</subject><subject>Fetal Death - blood</subject><subject>Fetal Death - genetics</subject><subject>Fetal Growth Retardation - blood</subject><subject>Fetal Growth Retardation - genetics</subject><subject>Fibrinolysis - genetics</subject><subject>Genetic Predisposition to Disease</subject><subject>Gestational Age</subject><subject>Heterozygote</subject><subject>Homozygote</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>nulliparous</subject><subject>Odds Ratio</subject><subject>PAI‐1</subject><subject>Parity</subject><subject>Phenotype</subject><subject>Plasminogen Activator Inhibitor 1 - genetics</subject><subject>Polymorphism, Genetic</subject><subject>Pre-Eclampsia - blood</subject><subject>Pre-Eclampsia - genetics</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - blood</subject><subject>Pregnancy Complications - genetics</subject><subject>Pregnancy Outcome</subject><subject>pre‐eclampsia</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Stillbirth - genetics</subject><subject>thrombophilia</subject><subject>Victoria</subject><issn>1538-7933</issn><issn>1538-7836</issn><issn>1538-7836</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNqNkc1O3DAUha2Kqvy0r1B52c2E69jOz4IFQnQAIbWL6dryODcdD0mc2glDdl2x5hl5EpwOsK43vrr-7rF9DiGUQcLiOt0mTPJikRc8S1JgaQIiB0gePpCj94ODt7rk_JAch7AFYKVM4RM5TFPB00zAEXlcbZD-PL9-_vvEqFieyiXtXTO1zvcbG1pqA-3cQHUIzlg9YEV3dthQ3VHbGY86xI634Y66murqHn1A2nv83enOTNSNg3EtRjYqTG0_uFYP1tBubBrba-_GQHcR6D6Tj7VuAn553U_Ir--Xq4urxe2P5fXF-e3CCFbCglfAdCFYLgzDAgRqaWSRZzKDcl2JIrZlzdgaBMTvcVmxWuZljSXka5bLjJ-Qb3vd3rs_I4ZBtTYYbBrdYXyMYpCCZABiRos9arwLwWOtem9b7acIqTkFtVWzwWo2W80pqH8pqIc4-vX1lnHdYvU--GZ7BM72wM42OP23sLpZXc0VfwH2Y5a7</recordid><startdate>201205</startdate><enddate>201205</enddate><creator>SAID, J. M.</creator><creator>TSUI, R.</creator><creator>BORG, A. J.</creator><creator>HIGGINS, J. R.</creator><creator>MOSES, E. K.</creator><creator>WALKER, S. P.</creator><creator>MONAGLE, P. T.</creator><creator>BRENNECKE, S. P.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201205</creationdate><title>The PAI‐1 4G/5G polymorphism is not associated with an increased risk of adverse pregnancy outcome in asymptomatic nulliparous women</title><author>SAID, J. M. ; TSUI, R. ; BORG, A. J. ; HIGGINS, J. R. ; MOSES, E. K. ; WALKER, S. P. ; MONAGLE, P. T. ; BRENNECKE, S. 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M.</creatorcontrib><creatorcontrib>TSUI, R.</creatorcontrib><creatorcontrib>BORG, A. J.</creatorcontrib><creatorcontrib>HIGGINS, J. R.</creatorcontrib><creatorcontrib>MOSES, E. K.</creatorcontrib><creatorcontrib>WALKER, S. P.</creatorcontrib><creatorcontrib>MONAGLE, P. T.</creatorcontrib><creatorcontrib>BRENNECKE, S. P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of thrombosis and haemostasis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SAID, J. M.</au><au>TSUI, R.</au><au>BORG, A. J.</au><au>HIGGINS, J. R.</au><au>MOSES, E. K.</au><au>WALKER, S. P.</au><au>MONAGLE, P. T.</au><au>BRENNECKE, S. P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The PAI‐1 4G/5G polymorphism is not associated with an increased risk of adverse pregnancy outcome in asymptomatic nulliparous women</atitle><jtitle>Journal of thrombosis and haemostasis</jtitle><addtitle>J Thromb Haemost</addtitle><date>2012-05</date><risdate>2012</risdate><volume>10</volume><issue>5</issue><spage>881</spage><epage>886</epage><pages>881-886</pages><issn>1538-7933</issn><issn>1538-7836</issn><eissn>1538-7836</eissn><abstract>Background:  Plasminogen activator inhibitor type 1 (PAI‐1) is an important regulator of fibrinolysis. A common deletion polymorphism that results in a sequence of 4G instead of 5G in the promoter region of the gene is associated with a small increase in the risk of venous thromboembolism. Its potential association with adverse pregnancy events remains controversial. Objective:  We aimed to assess the impact of the 4G PAI‐1 polymorphism on pregnancy outcomes in women who had no prior history of adverse pregnancy outcomes or personal or family history of venous thromboembolism. Patients/methods:  This study represents a secondary investigation of a prior prospective cohort study investigating the association between inherited thrombophilias and adverse pregnancy events in Australian women. Healthy nulliparous women were recruited to this study prior to 22 weeks gestation. Genotyping for the 4G/5G PAI‐1 gene was performed using Taqman assays in an ABI prism 7700 Sequencer several years after the pregnancy was completed. Pregnancy outcome data were extracted from the medical record. The primary outcome was a composite comprising development of severe pre‐eclampsia, fetal growth restriction, major placental abruption, stillbirth or neonatal death. Results:  Pregnancy outcome data were available in 1733 women who were successfully genotyped for this polymorphism. The primary composite outcome was experienced by 139 women (8% of the cohort). Four hundred and fifty‐nine women (26.5%) were homozygous for the 4G deletion polymorphism, while 890 (51.4%) were heterozygous. Neither homozygosity nor heterozygosity for the PAI‐1 4G polymorphism was associated with the primary composite outcome (homozygous OR = 1.30, 95% CI = 0.81–2.09, P = 0.28, heterozygous OR = 0.84, 95% CI = 0.53–1.31, P = 0.44) or with the individual pregnancy complications. Conclusion:  The PAI‐1 4G polymorphism is not associated with an increase in the risk of serious adverse pregnancy events in asymptomatic nulliparous women.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>22432640</pmid><doi>10.1111/j.1538-7836.2012.04700.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1538-7933
ispartof Journal of thrombosis and haemostasis, 2012-05, Vol.10 (5), p.881-886
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subjects Abruptio Placentae - blood
Abruptio Placentae - genetics
Adult
Asymptomatic Diseases
cohort study
Female
Fetal Death - blood
Fetal Death - genetics
Fetal Growth Retardation - blood
Fetal Growth Retardation - genetics
Fibrinolysis - genetics
Genetic Predisposition to Disease
Gestational Age
Heterozygote
Homozygote
Humans
Logistic Models
nulliparous
Odds Ratio
PAI‐1
Parity
Phenotype
Plasminogen Activator Inhibitor 1 - genetics
Polymorphism, Genetic
Pre-Eclampsia - blood
Pre-Eclampsia - genetics
Pregnancy
Pregnancy Complications - blood
Pregnancy Complications - genetics
Pregnancy Outcome
pre‐eclampsia
Prospective Studies
Risk Assessment
Risk Factors
Stillbirth - genetics
thrombophilia
Victoria
title The PAI‐1 4G/5G polymorphism is not associated with an increased risk of adverse pregnancy outcome in asymptomatic nulliparous women
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