Activated protein C resistance shows an association with pregnancy-induced hypertension

A common mutation in the factor V gene, the Leiden mutation, is the most frequent genetic cause of resistance to activated protein C (APC). Recent studies have shown that the prevalence of APC resistance is associated with severe pregnancy-induced hypertension (PIH). Our objective was to determine w...

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Bibliographic Details
Published in:Human reproduction (Oxford) 1999-12, Vol.14 (12), p.3112-3115
Main Authors: Horstkamp, B.S., Kiess, H., Krämer, J., Riess, H., Henrich, W., Dudenhausen, J.W.
Format: Article
Language:English
Subjects:
Adult
APC resistance
Biological and medical sciences
Diseases of mother, fetus and pregnancy
Drug Resistance
Factor V - analysis
Factor V - genetics
factor V Leiden mutation
Female
Gene Frequency
Gynecology. Andrology. Obstetrics
Heterozygote
Humans
Hypertension - blood
Hypertension - genetics
Hypertension - physiopathology
Medical sciences
placental infarction
Point Mutation
pre-eclampsia
Pregnancy
Pregnancy Complications - blood
Pregnancy Complications - physiopathology
pregnancy-induced hypertension
Pregnancy. Fetus. Placenta
Protein C - physiology
Reference Values
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Summary:A common mutation in the factor V gene, the Leiden mutation, is the most frequent genetic cause of resistance to activated protein C (APC). Recent studies have shown that the prevalence of APC resistance is associated with severe pregnancy-induced hypertension (PIH). Our objective was to determine whether the factor V Leiden mutation is more prevalent in patients who developed severe PIH than in normotensive pregnant women. In 70 women with a history of severe PIH, of whom 15 had pre-eclampsia, we investigated common coagulation factors as well as APC resistance (factor V related). We found that seven of these 70 women showed low values for APC. Out of these, five were heterozygous and none was homozygous for factor V Leiden mutation. In a control group of normotensive pregnant women we found a 3.0% rate of APC resistance and a 3.0% rate of carriers of the Leiden mutation. These results indicate a significantly higher prevalence of both APC resistance and factor V Leiden mutation in women with severe PIH. Placental infarctions and micro-embolisms are considered to be one of the principle pathophysiological changes in severe PIH. Our results suggest that APC resistance is a risk factor for severe PIH, in addition to its well-known role in macrothrombo-embolism.
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/14.12.3112