Published online August 1, 2006
PEDIATRICS Vol. 118 No. 2 August 2006, pp. 683-689 (doi:10.1542/peds.2005-2670)
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ARTICLE

Genetic Polymorphisms of Hemostasis Genes and Primary Outcome of Very Low Birth Weight Infants

Christoph Härtel, MDa, Inke König, PhDb, Stefan Köster, MDa, Evelyn Kattner, MDc, Eckhardt Kuhls, MDd, Helmut Küster, MDe, Jens Möller, MDf, Dirk Müller, MDg, Angela Kribs, MDh, Hugo Segerer, MDi, Christian Wieg, MDj, Egbert Herting, MD, PhDa and Wolfgang Göpel, MDa

a Department of Pediatrics
b Institute of Biometry and Statistics, University at Lübeck, Lübeck, Germany
c Kinderklinik auf der Bult, Hannover, Germany
d Olgahospital, Stuttgart, Germany
e Department of Pediatrics, University of Greifswald, Greifswald, Germany
f Children's Hospital Saarbrücken, Saarbrücken, Germany
g Children's Hospital Kassel, Kassel, Germany
h University of Cologne, Cologne, Germany
i Kinderklinik St Hedwig, Regensburg, Germany
j University of Aschaffenburg, Aschaffenburg, Germany

BACKGROUND. Recent investigations have reported an influence of thrombophilic mutations and antithrombotic risk factors with development of intraventricular hemorrhage. It was our objective for this study to investigate the impact of genetic polymorphisms of hemostasis genes on the primary outcome measures of sepsis, bronchopulmonary dysplasia, intraventricular hemorrhage, and periventricular leukomalacia in a large cohort of very low birth weight infants.

METHODS. There were 586 very low birth weight infants enrolled prospectively in a multicenter trial between September 2003 and July 2005, and an additional 595 very low birth weight infants, who had been recruited in a previous prospective trial, were studied. DNA samples were taken by buccal swab, and genotypes of factor V Leiden mutation, prothrombin G20210A mutation, the factor VII-323 del/ins polymorphism, and the factor XIII-Val34Leu polymorphisms were determined by polymerase chain reaction and restriction enzyme digestion.

RESULTS. In contrast to data published previously, the frequency of intraventricular hemorrhage or periventricular leukomalacia was not significantly influenced by any of the genetic variants tested. Carriers of the factor XIII-Val34Leu polymorphism, however, had a higher sepsis rate and a longer period of hospital care compared with noncarriers. The factor VII-323 del/ins polymorphism was found to be a potential protective factor against bronchopulmonary dysplasia.

CONCLUSIONS. We could not confirm previously reported associations of hemostasis gene variants and development of intraventricular hemorrhage in very low birth weight infants. To better understand gene-disease associations in very low birth weight infants, the prospective development of large-scale cohorts with well-defined phenotypes and corresponding DNA samples is essential.

Key Words: VLBW • outcome • hemostasis genes • polymorphism

Abbreviations: VLBW—very low birth weight • IVH—intraventricular hemorrhage • PVL—periventricular leukomalacia • BPD—bronchopulmonary dysplasia • ROP—retinopathy of prematurity

Accepted Mar 2, 2006.




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