Elucidation of genetic-environmental interaction and prevention for gestosis

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1.To clarify the interactions among the candidate gene polymorphisms for the occurrence of pregnancy-induced hypertension (PIH), we carried out genotyping of the genes associated with blood coagulation, such as C677T of methylenetetrahydrofolate reductase gene, Leiden mutation of factor V gene, G20210A of prothrombin gene and 4G/5G of plasminogen actibator inhibitor gene (PAI-I). The results showed that frequencies of 4G/4G of PAI-I ware 41% in PIH cases and 39% in controls, and no significant difference was found between them. However, frequencies of homozygote of T235 of angiotensinogen gene (AGT), which is reported risk factor for PIH, were significantly higher in PIH cases (78%, n=56) than controls (56%, n=121) in the subgroup possessing 4G/4G of PAI-I (p=0.008), while no significant difference was found between PIH cases (71%, n=82) than controls (60%, n=202) in the subgroup possessing 5G/5G or 4G/5G of PAI-I. Frequencies of heterozygote of Glu298Asp or homozygote of Asp298 of the endotherial nitric oxide synthase gene (NOS3), which is also reported risk factor for PIH, were 18% in PIH cases (n=51) and 10% in controls (n=114) in the subgroup possessing 4G/4G, and 30% in PIH cases (n=74) and 15% in controls (n=190) in the subgroup possessing 5G/5G or 4G/5G of PAI-I. Significant difference was found only in the latter subgroup (p<0.008).2.In order to develop a stress checklist for pregnant women to use examinations and interventions, we performed personal interview and focus group interview in obstetrical department. Emesis, body change by pregnancy, health control methods during pregnancy, economical burden, relationship to parents, child care in the near future, etc. were found to be the stress factors of the pregnant women.