الفهرس 
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Abstract
Pre-eclampsia (PE) is a multi-organ disorder defined as elevated blood pressure (>140/90 mmHg) and proteinuria that may develop after 20 weeks gestation. PE is the first cause of maternal death in the western world and affects 5 to 8% of pregnant women, depending on the studied population and definitions of PE.
Clinically disease may also be associated with abnormalities of the central nervous system, the liver, the kidneys, and intra-vascular disseminated coagulation.
The aim of this study is to test for the association of common mutations of the vascular endothelial growth factor (VEGF) gene including C936T and C2578A polymorphisms with pre-eclampsia among Egyptian women. The relation between these genetic variants will be also tested with different demographic and clinical characteristics of cases.
The study participants included 170 female subjects. Out of them, 100 had a history of preeclampsia. Their mean age ± SD was 25.28 ± 4.59 years. Seventy nine (79%) cases had a history of mild preeclampsia and 21 (21%) cases had a history of severe preeclampsia. Fifty one (51%) cases were primigravida while, 49 (49%) were multigravida. Forty one (41%) cases had positive family history while, 59 (59%) cases had negative family history. Sixty nine (69%) cases had systolic blood pressure between 140 to 160 mm Hg and 31 (31%) cases had systolic blood pressure more than 160 mm Hg. Forty five (45%) cases had diastolic blood pressure between 90 to 110 mm Hg and 55 (55%) cases had diastolic blood pressure more than 110 mm Hg. Seventy three (73%) cases had gestational age less than or equal to 36 weeks while, 27 (27%) cases had gestational age more than 36 weeks. The other 70 subjects were clinically healthy unrelated women with a history of complete successful pregnancy and no preeclampsia. Their mean age ± SD was 23.73 ± 2.80 years.
This study revealed a statistically significant difference higher frequency of homozygous mutant genotype (AA) of VEGF C2578A gene among cases compared to controls, manifested by a very high odds ratio [OR= 25.6, P= 0.00]. Also, there is a statistically significant difference lower frequency of normal wild genotype (CC) in VEGF C2578A gene among cases compared to controls [OR= 0.3, P= 0.00].
On the other hand, there is no statistically significant difference in the frequency of homozygous mutant genotype (TT) in VEGF C936T gene among cases compared to controls [OR=NA, P=NA]. The same was observed on analysis the normal wild type (CC) in VEGF C936T gene among cases compared to controls [OR= 0.80, P= 0.59].
Nonetheless, on analysis of the results related the combined VEGF C936T and C2578A genotypes mutations, the present study showed a significantly higher frequency of combined VEFG 936 homozygous wild genotype form (CC) with a VEGF 2578 homozygous mutant genotype form (AA) (10% vs. 0.0%, OR= 16.36, P= 0.00) and also significantly higher frequency of combined VEGF 936 homozygous wild genotype form (CC) with VEGF 2578 heterozygous mutant genotype form (CA) in cases than controls (43% vs. 18%, OR= 2.18, P= 0.02). Interestingly, neither cases nor controls showed a combined homozygous mutant genotypes 936TT/2578AA.
In conclusion, there was a strong association between the presence of preeclamptic mutations related to VEGF C936T and C2578A gene among Egyptian women. This might warrant adoption of screening program not only for cases of preeclampsia but also as a routine testing for all women.