
INHERITED THROMBOPHILIAS COULD INFLUENCE THE REPRODUCTIVE OUTCOME IN WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS
robeva r1,*, Tanev D2, andonova S3, Nikolova M4, Tomova a1, Kumanov Ph1, Savov a3, Rashkov R2, Kolarov Zl2,* *Corresponding Author: Professor Zlatimir Kolarov, M.D., Ph.D., D.MSc., Clinic of Rheumatology, Medical University Sofia, 13 Urvich Str., Sofia 1612, Bulgaria. Tel: +359-2-958-93-91. Fax. +359-2-958-23-31. E-mail: zkolarov@abv.bg and Ralitsa Robeva, M.D., Ph.D., Clinical Center of Endocrinology and Gerontology, Medical University Sofia, 2 Zdrave Str., Sofia 1431, Bulgaria. Tel: +359-2-895-60-40. Fax: +359-2-987-41-45. E-mail: rali_robeva@yahoo.com page: 21
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RESULTS
No significant differences in the prevalence of the
FVleiden, FIIg20210a and MTHFRC677T polymorphisms between patients and controls were established (Table 1), although the frequency of heterozygous MTHFRC677T carriers in SLE patients was increased. The differences in the reproductive history of patients with FVleiden or FIIg20210a polymorphisms are presented on Table 2. Patients with FVleiden had fewer pregnancies and live births than the others, while no significant differences in the reproductive history of FIIg20210a carriers and non-carriers were observed (Table 2). The logistic regression analysis showed that the presence of FVleiden but not the FIIg20210a decreased significantly the chance for having at least one live birth even after adjustment for the current age of patients and the presence of sAPS [0.041 (0.004-0.400), p = 0.006]. The FVleiden or FIIg20210a polymorphisms did not influence significantly the risk for at least one unsuccessful pregnancy (miscarriage or stillbirth) (p >0.05). The reproductive history of patients according to the presence of MTHFRC677T polymorphism is presented in Table 2. Among women with the TT genotype, 41.67% had at least one miscarriage in comparison to 14.00% of the other female patients (p = 0.030), while the prevalence of self-reported infertility and number of pregnancies was similar in MTHFRC677T TT homozygotes in comparison to MTHFRC677T C allele carriers. The presence of MTHFR C677T TT increased more than three times the risk for at least one miscarriage in SLE patients after adjustment for age [odds ratio (OR) 3.827 (1.013-14.459), p = 0.048] but the association was attenuated after adjustment for age and sAPS
[OR 2.765 (0.607-12.604), p = 0.189]. Recurrent pregnancy loss (two or more miscarriages) was reported by six (5.4%) of the patients. It was not related to any of the investigated polymorphisms (p >0.1 for all).
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