G20210A prothrombin gene mutation: Prevalence in a recurrent miscarriage population

Many recurrent pregnancy losses appear to have a thrombotic etiology. We ha ve investigated the prevalence of the G20210A prothrombin gene mutation in 122 women with a history of three or more early (less than or equal to 12 w eeks gestation; n = 91), late (> 12 weeks gestation; n = 2), or mixed (n = 29) consecutive pregnancy losses. A control group of 66 healthy parous wome n with no history of thrombosis or miscarriage was also studied. Four heter ozygotes that suffered only early pregnancy losses were detected in the pat ient group giving a prevalence of 3.3%. Three of the control group women we re heterozygous for the mutation, giving a prevalence of 4.5% (p = 0.32; od ds ratio 0.71; 95% confidence interval [CI] 0.15-3.27). When only Caucasian s were analyzed, a prevalence of 3.9% (4/103) was observed in the patient g roup and 4.2% (2/48) in the control group (p = 0.28; odds ratio 0.89; 95% C I 0.16-5.05). The prevalence of the G20210A prothrombin gene mutation is ri ot increased in women with recurrent miscarriage, although it was only foun d in women who had suffered early pregnancy losses. However, it remains pos sible that this mutation is relevant in a selected subgroup of women with r ecurrent miscarriage, additional thrombophilic defects, and in whom fetal l oss is associated with placental infarction and thrombosis.