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Maternal Carriage of the Annexin A5 M2 Haplotype Combined with Inherited or Acquired Thrombophilia Would Synergistically Increase the Risk of Suffering Intra Uterine Growth Restriction

1Hospital de Infecciosas F.J. Muñiz, Buenos Aires, Argentina, 2Hospital General de Agudos C.G. Durand, Buenos Aires, Argentina, 3Hospital General de Agudos D. F. Santojanni, Buenos Aires, Argentina, 4Maternidad Santa Rosa, Buenos Aires, Argentina

Abstract Number: PB2541

Meeting: ISTH 2020 Congress

Theme: Women Health » Pregnancy and Pregnancy Complications

Background: Annexin A5 (ANXA5) is a protein abundantly expressed in normal placenta where it was proposed to exert an anticoagulant function. As the carrier status of the M2/ANXA5 promoter haplotype results in a significantly reduced expression of placental ANXA5, it was proposed to be involved in the etiology of obstetric complications of vascular origin. However, different studies yielded conflicting evidence, similarly to the controversial role of inherited thrombophilia.

Aims: Our aim was to assess the association between maternal carriage of the M2/ANXA5 haplotype and obstetric pathologies in which placental vascular complications could have a key role.

Methods: 283 women with recurrent pregnancy loss (RPL) and 114 parous controls without pregnancy complications were recruited. Patients were stratified according to the timing of miscarriages: early (˂10 weeks), late (≥10 weeks) and fetal losses (≥20 weeks) and having suffered or not intra-uterine growth restriction (IUGR) and/or pre-eclampsia (PE). Differences in the maternal M2/ANXA5 carriage rate between groups were assessed using the chi-square test. The odds ratio (OR) was estimated by binary logistic regression adjusted for potential confounding variables.

Results: Our results showed an association between maternal carriage of M2/ANXA5 and IUGR, but neither association was found with the timing of pregnancy losses nor with PE (Fig. 1) However, logistic regression analysis showed that maternal carriage of M2/ANXA5 would not be an independent risk factor for IUGR but when combined with either acquired or hereditary thrombophilia, it would increase the odds of suffering this obstetric pathology (OR=6.26; 95%CI [1.99-19.06]).

Conclusions: As with inherited thrombophilia, the role of the ANXA5 M2 haplotype in obstetric complications of vascular origin has been a matter of debate. Our results showed that maternal carriage of M2/ANXA5 would not be associated with the timing of RPL or PE, but when combined with either inherited or acquired thrombophilia might act synergistically increasing the risk of IUGR.


[Fig 1. Maternal M2/ANXA5 carriage rate among clinical subgroups of patients and controls]

To cite this abstract in AMA style:

Aranda F, Udry S, Micone P, Claus L, Salinas P, Perés S, Lucero A, Moiana M, Latino JO, de Larrañaga G. Maternal Carriage of the Annexin A5 M2 Haplotype Combined with Inherited or Acquired Thrombophilia Would Synergistically Increase the Risk of Suffering Intra Uterine Growth Restriction [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/maternal-carriage-of-the-annexin-a5-m2-haplotype-combined-with-inherited-or-acquired-thrombophilia-would-synergistically-increase-the-risk-of-suffering-intra-uterine-growth-restriction/. Accessed December 11, 2023.

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