Abstract
Background : Half of venous thromboembolism (VTE) cases during pregnancy are associated with a maternal thrombophilia. An influence of paternal particularities expressed by the placenta in the genesis of those VTE has not been described. Objectives : To determine if the maternal and paternal Ser219Gly dimorphism of the endothelial protein C receptor (EPCR), evaluated through the PROCR 6936G allele, is a risk factor for VTE during pregnancy. Methods : Case-control study, nested in the NOHA first cohort of primigravidae. Sixty six patient couples with a first episode of gestational VTE and their randomly selected nonthrombotic control couples were investigated for factor V gene (F5) G1691A, factor II gene (F2) G20210A, factor XII gene (F12) C46T and PROCR A6936G polymorphisms. Results : Only maternal F5 1691A, F2 20210A and F12 46T alleles were independently associated with iliac and infra-iliac deep vein thromboses (DVT). The maternal PROCR 6936G allele was a mild risk factor for iliac DVT: 5.5 [2.3 -13.0]. The paternal PROCR 6936G allele was also a mild independent risk factor for iliac DVT (OR=2.6 [1.1 -6.2]) and only during pregnancy among mothers carriers of the F5 1691A allele (OR= 77.6 [4.2 ->999.9]), not postpartum.Conclusions : The paternal PROCR 6936G allele could be a risk factor for maternal iliac DVT. Its impact was milder than the F5 1691A and F2 20210A polymorphisms in mothers.</p><p>One can hypothesize that its prothrombotic effect is purely local. Thus DVT determinism during pregnancy could be partly modulated through trophoblastic cell-surface expressed variants inherited from both members of the couples.