MTHFR Normal 1st Pregnancy, Not so Normal 2nd?

[riehlism]

I am having concerns for my sister who is 14 weeks pregnant. I had severe early onset PE at 23 weeks and subsequently lost my son. I just found out today I have MTHFR genetic mutation.

She had a fairly normal pregnancy with her first baby. She went into early pre-term labor at 32 weeks, but they were able to stop the contractions and she delivered and healthy baby boy at 37 weeks October 2008. She's had 2 miscarriages since and is now 14 weeks pregnant.

Would it be possible to have MTHFR and have a healthy first, but PE in the second?

[caryn]

MTHFR has incredibly common polymorphisms; most people with MTHFR variants have normal pregnancies and deliveries.

If your mother or sister have a history of preeclampsia, your risk for preeclampsia is substantially elevated -- I believe to 25% but will have to check -- although a first pregnancy with no preeclampsia is promising. However, PTL and two miscarriages might imply some level of maternal-fetal conflict that's getting to the point where it interferes substantially.

[caryn]

I'm not sure which polymorphism you're carrying, but:

Here's a [url="http://www.ncbi.nlm.nih.gov/pubmed/20027027"]recent finding[/url] from PubMed: Homozygous carriers of the MTHFR 1298 polymorphism had an odds ratio of 0.26 (95% CI 0.08-0.86, P=.03). None of the other polymorphisms studied showed a significant association with the development of the primary outcome in this cohort of women.

Here's [url="http://www.ncbi.nlm.nih.gov/pubmed/19853876"]another[/url]: CYBA and APOE polymorphism showed a different distribution in the groups studied, while no differences were observed in MTHFR C677T polymorphism.

Here's [url="http://www.ncbi.nlm.nih.gov/pubmed/18712057"]another[/url]: The MTHFR 677T allele and the 677TT genotype were significantly more frequent in the controls, suggesting an association with a decreased risk of preeclampsia (p = 0.017 and p = 0.007, respectively).

One Expert has said [url="http://www.preeclampsia.org/forum/viewtopic.php?t=4860"]here[/url] that MTHFR does not cause preeclampsia. You need no treatment & no supplements.

[url="http://www.ncbi.nlm.nih.gov/pubmed/20423274"]Sibling and family history[/url] of hypertension or preeclampsia raises risk: The risk of preeclampsia was greater when the woman had a sister with a history of hypertension (OR 2.60, 95% CI 1.60-4.21, p < 0.001), preeclampsia (OR 2.33, 95% CI 1.58-3.45, p < 0.001), or eclampsia (OR 2.57, 95% CI 1.28-5.16, p = 0.008). The risk of preeclampsia was also higher for women who had both a mother and sister with a history of hypertension (OR 3.65, 95% CI 1.65-8.09, p = 0.001).

Hope this helps!