Thromb Haemost 2009; 102(04): 656-667
DOI: 10.1160/TH-09-04-0224
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

The A6936G polymorphism of the endothelial protein C receptor gene is associated with the risk of unexplained foetal loss in Mediterranean European couples

Éva Cochery-Nouvellon*
1   Haematology Laboratory, University Hospital, Nîmes, France
5   Research team EA2992, Montpellier1 University, Montpellier, France
,
Céline Chauleur*
6   Research team EA3065, St Etienne, France
,
Christophe Demattei*
2   Department of Biostatistics, clinical Epidemiology, public Health and Medical Information, University Hospital, Nîmes, France
,
Éric Mercier*
1   Haematology Laboratory, University Hospital, Nîmes, France
4   Haematology Laboratory, Faculty of Pharmacy, Montpellier1 University, Montpellier, France
5   Research team EA2992, Montpellier1 University, Montpellier, France
,
Pascale Fabbro-Peray
2   Department of Biostatistics, clinical Epidemiology, public Health and Medical Information, University Hospital, Nîmes, France
,
Pierre Marès
3   Department of Gynaecology and Obstetrics, University Hospital, Nîmes, France
,
Patrick Mismetti
6   Research team EA3065, St Etienne, France
,
Géraldine Lissalde-Lavigne
1   Haematology Laboratory, University Hospital, Nîmes, France
5   Research team EA2992, Montpellier1 University, Montpellier, France
,
Jean-Christophe Gris
1   Haematology Laboratory, University Hospital, Nîmes, France
4   Haematology Laboratory, Faculty of Pharmacy, Montpellier1 University, Montpellier, France
5   Research team EA2992, Montpellier1 University, Montpellier, France
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Publikationsverlauf

Received: 03. April 2009

Accepted after major revision: 27. Juni 2009

Publikationsdatum:
24. November 2017 (online)

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Summary

The endothelial protein C receptor (EPCR) is expressed by trophoblast cells. Mid-gestation pregnancy loss is described in animals with a haemochorial placenta lacking EPCR. The A6936G allele of the EPCR gene (PROCR) may be associated with lower EPCR densities on trophoblasts, but data are lacking for its effect on the risk of pregnancy loss in humans. A 1:2 case-control study on unexplained pregnancy loss was nested in the NOHA First cohort: 3,218 case couples and 6,436 control couples were studied for PROCR A6936G, coagulation factor V gene (F5) G1691A and coagulation factor II gene (F2) G20210A polymorphisms. Ethnicity and time of pregnancy loss defined through biometry-based gestational ages (embryonic loss < 10th week ≥ foetal loss) were analysed. The PROCR A6936G allele, in mothers and fathers, was associated only with foetal loss in both Europeans and non-Europeans. Increasing probability levels of carrying a homozygous child were increasingly associated with the risk of foetal demise. The F5 G1691A and F2 G20210A alleles, only in mothers, were only and independently associated with foetal loss in Europeans. In our population, the PROCR A6936G allele describes women, but also men and thus couples, at risk for first unexplained foetal loss. This risk is independent of the foetal loss risk conferred to our local Mediterranean European women by the F5 G1691A and F2 G20210A alleles. Data confirm that the relationship between thrombophilias and pregnancy loss varies according to ethnicity and loss type.

* * These four co-authors contributed equally to the work.