Increased incidence of obstetric complications in women carrying mitochondrial DNA mutations: a retrospective cohort study in a single tertiary centre. (7th February 2019)

• Record Type: Journal Article
• Authors: Kuleva, M; Ben Miled, S; Steffann, J; Bonnefont, JP; Rondeau, S; Ville, Y; Munnich, A; Salomon, LJ
• Is Part Of: BJOG. Volume 126:Number 11(2019)
• Page Start: 1372
• Page End: 1379
• Publication Date: 2019-02-07
• Subjects: Mitochondrial disease -- OXPHOS mutations -- pregnancy complications; Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.15515
• Languages: English
• ISSNs: 1470-0328

Abstract

Abstract : Objective: To investigate the obstetric outcome of women carriers of the oxidative phosphorylation (OXPHOS) disorder mutation. Design: A retrospective cohort study in a single tertiary centre. Setting: A review of the obstetric history of women referred for prenatal screening of a mitochondrial disorder was performed. Population: Women were divided into three groups: (1) women carrying mitochondrial DNA (mtDNA) mutations; (2) healthy women with a family history of mtDNA‐related OXPHOS disorder; and (3) healthy women carrying heterozygote nuclear DNA mutations. Methods: Obstetric history and pregnancy complications were evaluated separately in the three groups and compared with the control group. Main outcome measures pregnancy complications.Results: Seventy‐five women were included with 287 cumulative pregnancies. Groups 1 and 3 had a significantly greater proportion of terminations of pregnancy (20 and 13% versus 0.8%, P < 0.001), and a lower percentage of live births (52 and 72% versus 87%, P = 0.001), compared with controls. Apart from this, the rate of obstetric complications in group 3 did not differ from the controls. The obstetric history of women in group 1 was marked by higher rates of early miscarriages (26 versus 11%, P = 0.004), gestational diabetes (14 versus 3%, P = 0.02), intrauterine growth restriction (IUGR, 10 versus 1%, P = 0.008), and postpartum haemorrhage than were reported for controls (12 versus 2%, P = 0.01). Conclusion: Women who are heteroplasmic for OXPHOS mutations have a higher incidence of pregnancy losses, gestational diabetes, IUGR, and post postpartum haemorrhage. Tweetable abstract: Women heteroplasmic for mitochondrial DNA mutations have a higher incidence of obstetric complications, compared with the control group. Tweetable abstract: Women heteroplasmic for mitochondrial DNA mutations have a higher incidence of obstetric complications, compared with the control group.