PREECLAMPSIA AND TRISOMY-13

Objective To assess the reported association between field trisomy 13 and maternal pre-eclampsia. Design A retrospective case-control study. Subjects Twenty-five women who gave birth to trisomy 13 infants in southwest England between 1971 and 1989; 38 women who gave birth to trisomy 18 infants in the same region over the same time and 50 women with normal karyotype infants matched for age, parity, and date of delivery with the trisomy 13 group. Main outcome measures The medical records of all the women in the three groups were analysed for evidence of pre-eclampsia. Four different thresholds of pre-eclampsia were used. The incidence of pre-eclampsia was compared between the three study groups and analysed separately for primigravid and multigravid women. Results The incidence of pre-eclampsia in pregnancies complicated by trisomy 13 was significantly higher than the incidence in the trisomy 18 and the normal karyotype control groups. This association was more pronounced in primigravid pregnancies. Conclusions This, the largest survey of trisomy 13 and pre-eclampsia to date, suggests an association between the two conditions. It also supports the argument for a fetal factor in the pathogenesis of pre-eclampsia. We speculate on how genes encoded on chromosome 13 may be responsible.