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Résumé :
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[BDSP. Notice produite par INIST-CNRS 8AlR0xks. Diffusion soumise à autorisation]. Severe preeclampsia is a common cause of maternal and perinatal morbidity worldwide. The disease clusters in families ; however, individual genetic studies have produced inconsistent results. We conducted a review to examine relationships between maternal genotype and severe preeclampsia. We searched the MEDLINE and Embase databases for prospective and retrospective cohort and case-control studies reporting associations between genes and severe preeclampsia. Four reviewers independently undertook study selection, quality assessment, and data extraction. We performed random-effects meta-analyses by genotype and predefined functional gene group (thrombophilic, vasoactive, metabolic, immune, and cell signalling). Fifty-seven studies evaluated 50 genotypes in 5,049 cases and 16,989 controls. Meta-analysis showed a higher risk of severe preeclampsia with coagulation factor V gene (proaccelerin, labile factor) (F5) polymorphism rs6025 (odds ratio=1.90,95% confidence interval : 1.42,2.54 ; 23 studies, I2=29%), coagulation factor II (thrombin) gene (F2) mutation G20210A (rs1799963) (odds ratio=2.01,95% confidence interval : 1.14,3.55,9 studies, I2=0%), leptin receptor gene (LEPR) polymorphism rs1137100 (odds ratio=1.75,95% confidence interval : 1.15,2.65 ; 2 studies, I2=0%), and the thrombophilic gene group (odds ratio=1.87,95% confidence interval : 1.43,2.45, I2=27%). There were no associations with other gene groups. There was moderate heterogeneity between studies and potential for bias from poor-quality genotyping and inconsistent definition of phenotype. Further studies with robust methods should investigate genetic factors that might potentially be used to stratify pregnancies according to risk of complications.
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