The association of parental methylenetetrahydrofolate reductase polymorphisms (MTHFR 677C > T and 1298A > C) and fetal loss: a case–control study in South Australia. (3rd March 2020)

• Record Type: Journal Article
• Authors: Kos, Britt J. P.; Leemaqz, Shalem Y.; McCormack, Catherine D.; Andraweera, Prabha H.; Furness, Denise L.; Roberts, Claire T.; Dekker, Gustaaf A.
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 33:Number 5(2020)
• Page Start: 752
• Page End: 757
• Publication Date: 2020-03-03
• Subjects: Fetal loss -- hyperhomocysteinemia -- methylenetetrahydrofolate reductase -- MTHFR -- pregnancy loss; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2018.1500546
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective: To determine the association between parental MTHFR 677C > T (RS1801133) and 1298A > C (RS1801131), and fetal loss (FL). Design: Case–control study. Setting: Department of Obstetrics and Gynecology, Lyell McEwin Hospital (LMH), and the Women's and Children's Hospital (WCH) in Adelaide, Australia. Patients: A total of 222 couples with FL and 988 couples with uncomplicated pregnancies. Measurements: The main outcomes were FL and hyperhomocysteinemia (HHcy). All couples were tested for MTHFR 677C > T and 1298A > C. Fasting homocysteine was measured in the women with FL. Results: The main finding was a significant difference between the FL group and controls in couples with ≥4 abnormal alleles compared to <4 [p=.0232, OR 1.9 (95% CI 1.1–3.3)]. None of the couples with FL had zero abnormal alleles (both parents 677CC/1298 AA). However, this was also rare amongst the controls. Maternal carriage of both 677C > T and the 1298A > C polymorphisms was similar between the FL group and controls. The prevalence of paternal 677TT/1298AA and 677CC/1298AC was significantly higher in the FL group compared with controls. HHcy was significantly more common in the FL group compared with controls. Conclusion: The presence of parental MTHFR 677C > T and 1298A > C is associated with FL. The association between maternal MTHFR genotypes with FL is less pronounced than in previously published articles investigating first trimester miscarriages. Maternal HHcy is a significant risk factor for FL.