ABO(H) blood groups and pre-eclampsia - A systematic review and meta-analysis
Department of Transfusion Medicine, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK. Thrombosis and Haemostasis
(Impact Factor: 4.98).
10/2008; 100(3):469-74. DOI: 10.1160/TH08-05-0302
Pre-eclampsia is associated with both placental thrombosis and thrombophilia. The ABO(H) blood group influences von Willebrand factor, which is a risk factor for arterial and venous thrombosis. Over many years a number of studies have examined the relationship between ABO(H) and pre-eclampsia, but no consensus exists as to whether there is a true association. Correspondingly, a systematic review of studies reporting an association between ABO(H) blood group and pre-eclampsia syndromes was performed. From the 17 eligible studies there was no consistent link between blood group AB and pre-eclampsia, with a pooled odds ratio of group AB versus the remainder of 1.02 (95%CI 0.86 to 1.22). There was no evidence of heterogeneity and individual study estimates were relatively consistent. Comparing a combined group of non-Os (i.e. AA, AB and BB) with group O gave similar results, with a pooled odds ratio of 1.01 (95%CI 0.91 to 1.12), but with some evidence of heterogeneity (p=0.01) and individual study estimate inconsistency (I(2) 49%). However, no specific feature (disease definition, disease severity, date of publication, or ABO(H) distribution in controls) distinguished those few studies giving any form of positive association from the remainder. In summary, no clear association between any ABO(H) blood group and pre-eclampsia can be made from available studies. However, existing data does not allow exclusion of an effect limited to those expressing the least O(H) antigen.
Available from: Hiten D Mistry
- "Previous studies that report a positive relationship between blood groups and pre-eclampsia were conducted in different countries which have different characteristics of the blood phenotypes and used different criteria to characterize preeclampsia . Thus this association might be investigated with conflicting results  . For example, in Iraq, there was a significant decrease in group O type in patients with pre-eclampsia compared to healthy controls  and in Colombia patients with Rh(À) were eleven times more likely to develop pre-eclampsia compared with the Rh(+) factor . "
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ABSTRACT: The purpose of the present study was to evaluate the association between pre-eclampsia and blood groups in a group of pregnant women hospitalized in a University Hospital in Porto Alegre, Brazil - Hospital São Lucas (HSL)/PUCRS.
Our sample consisted of 10,040 pregnant women admitted to the maternity department of HSL between 2005 and 2010. The patients were reviewed retrospectively for inclusion. Medical records of 414 women were diagnosed as preeclampsia/eclampsia and 9611 women were identified to the control group. The patients were divided into two groups: the group with preeclampsia/eclampsia and the control group, and their blood groups were considered. Data were analyzed using SPSS for Windows version 17.0. Categorical data were summarized by counts and percentages, with the statistical significance evaluated by the Chi-square test. The null hypothesis was rejected when p<0.05.
Maternal parameters were compared between control group and pre-eclampsia, respectively, Systolic Blood Pressure (117±19.98 vs. 165±19.99); Diastolic Blood Pressure (73±14.23 vs. 106±14.24) and maternal weight at booking (73±33 vs. 83±33). For all data: mean+SD; p<0.05. In relation to blood groups, firstly they were stratified by Rh and ABO phenotypes, separately. After that the groups were put together.
No differences in blood group distribution were observed between controls and pre-eclampsia for any analysis. (p>0.05).
When we adopted stricter criteria for pre-eclampsia and a large sample from the same region we noted that the results did not show any association between blood groups and the development of pre-eclampsia.
Copyright © 2014 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.
Pregnancy Hypertension 04/2014; 4(2). DOI:10.1016/j.preghy.2014.03.003
Available from: Yves Jacquemyn
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ABSTRACT: Inadequate trophoblast invasion of the spiral arteries in early pregnancy, an increased inflammatory response and changes in the immune answer to paternal antigens are considered aetiological factors in preeclampsia. Searching for factors related to these angiogenic, anti-angiogenic, immunologic and inflammatory mechanisms may provide methods to determine which patient will develop preeclampsia predating the onset of the clinical manifestations of the disease. Screening for preeclampsia in the first trimester has had Limited success. Currently, maternal characteristics, clinical history, maternal serum biochemistry and uterine artery Doppler sonography before 14 weeks are being investigated. Preeclampsia in a previous pregnancy is still the strongest predictor. In the second trimester, uterine artery Doppler has a detection rate around 60% but also a high false positive rate of 25%. First trimester uterine artery Doppler studies have high sensitivity but poor specificity with a high false positive rate. Combination of first trimester uterine artery Doppler with patient characteristics and maternal serum biochemistry, specifically placental protein 13 holds promise but further evaluation is needed. Maternal serum markers including inhibin A, activin A, soluble FMS-Like tyrosine kinase 1, endoglin, pregnancy associated plasma protein A and others, when used alone have proved poor predictors of preeclampsia. Most studies have been performed by a limited group of researchers in a population with a high risk and no validation studies of any method in other populations are available. Results are difficult to compare due to differences in methodology, and differences in the end point studied.There are still no good methods of preventing preeclampsia once a high risk has been determined.
Acta clinica Belgica 01/2010; 65(1):1-12. DOI:10.1179/acb.2010.001 · 0.59 Impact Factor
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ABSTRACT: Our objectives were to assess inherited thrombophilia and non-O blood group for the risk of gestational vascular complications among the Tunisian population.
This study comprised 203 test subjects with adverse pregnancy outcomes including recurrent pregnancy loss, intra-uterine growth retardation, pre-eclampsia and placental abruption. Each subgroup was matched with 100 controls and analyzed separately. All patients were evaluated for factor V Leiden, factor II G20210A mutations and for non-O blood group. Protein S, protein C and antithrombin levels were determined and deficiencies noted.
The factor V Leiden mutation, non-O blood group and protein C deficiency had the highest incidences among patients both as a whole and in the 4 subgroups. The factor II G20210A mutation, protein S and antithrombin deficiencies were not statistically significant risk factors.
Our results provide evidence for a significant association between the factor V mutation and placental abruption. Furthermore, we found that this and the non-O blood group independently increased the risk for intra-uterine growth retardation in our population.
Acta Haematologica 11/2010; 125(3):115-20. DOI:10.1159/000321934 · 1.12 Impact Factor
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