The GOAL study: a prospective examination of the impact of factor V Leiden and ABO(H) blood groups on haemorrhagic and thrombotic pregnancy outcomes
The GOAL study: a prospective examination of the impact of factor V Leiden and ABO(H) blood groups on haemorrhagic and thrombotic pregnancy outcomes
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DOI：
10.1111/j.1365-2141.2007.06902.x
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发表时间：
2008-01-01
影响因子：
6.5
通讯作者：
Greer, Ian A.
中科院分区：
文献类型：
--
作者：
Clark, Peter;Walker, Isobel D.;Greer, Ian A.
因子V莱顿（FVL）和ABO(H)血型是止血的共同影响因素，回顾性研究已将FVL与妊娠并发症联系起来。然而，只进行了一次大规模的前瞻性检查。因此，无论是FVL对未选择受试者的影响，与妊娠ABO(H)的任何相互作用，还是FVL筛查的效用都没有定义。对4250名未被选择的孕妇进行了一项前瞻性研究。观察到静脉血栓栓塞（VTE）率为1.23/1000，但FVL与先兆子痫、宫内生长受限或妊娠丢失无显著相关性。未观察到FVL和/或ABO(H)对产前出血、产中和产后出血的影响。然而，FVL与出生体重相关[比值比（OR） 1.81；95%可信区间（CI95） 1.04-3.31)和新生儿死亡（OR 14.79; CI95 2.71-80.74）。ABO(H)与FVL无单独关系，ABO(H)与FVL无相互作用。我们既没有证实FVL对先前小型研究中报道的妊娠相关失血的保护作用，也没有发现回顾性研究中报道的一些血管并发症的风险增加。
Factor V Leiden (FVL) and ABO(H) blood groups are the common influences on haemostasis and retrospective studies have linked FVL with pregnancy complications. However, only one sizeable prospective examination has taken place. As a result, neither the impact of FVL in unselected subjects, any interaction with ABO(H) in pregnancy, nor the utility of screening for FVL is defined. A prospective study of 4250 unselected pregnancies was carried out. A venous thromboembolism (VTE) rate of 1.23/1000 was observed, but no significant association between FVL and pre-eclampsia, intra-uterine growth restriction or pregnancy loss was seen. No influence of FVL and/or ABO(H) on ante-natal bleeding or intra-partum or postpartum haemorrhage was observed. However, FVL was associated with birth-weights > 90th centile [odds ratio (OR) 1.81; 95% confidence interval (CI95) 1.04-3.31] and neonatal death (OR 14.79; CI95 2.71-80.74). No association with ABO(H) alone, or any interaction between ABO(H) and FVL was observed. We neither confirmed the protective effect of FVL on pregnancy-related blood loss reported in previous smaller studies, nor did we find the increased risk of some vascular complications reported in retrospective studies.