Researchers have discovered several genetic variations associated with a greater risk for post-partum hemorrhage. The affected genes appear to be involved in immune responses and cell interactions, suggesting new mechanisms underlying the risk of hemorrhage, according to a genome-wide association study presented October 3 at the virtual annual conference of the American Society of Anesthesiologists. "Determining which signaling pathways of immunity and inflammation may play a role can help us look for drug targets in the future to design medications that may protect from or treat postpartum hemorrhage," Dr. Vesela Kovacheva of Brigham and Women's Hospital in Boston, who worked on the study, told Reuters Health by email. Dr. Kovacheva and colleagues gleaned data from the more than 500,000 participants in UK Biobank, a prospective study of the roles of genes and environmental exposure in the development of disease. Using International Classification of Diseases (ICD) codes, the researchers identified 1,424 patients who suffered post-partum hemorrhage, matching them to 4,272 women who had had at least one live birth and no hemorrhaging. The team used linear mixed models and an additive genetic model to identify three single-nucleotide polymorphisms (SNP) that met their threshold of significance for association with post-partum hemorrhage (P<5x10-8). One SNP is near the LGALS3BP gene, which governs interactions between cells and interactions between cells and matrices, as well as the innate immune system's natural killer cells and lymphokine-activated killer cytotoxicity. A second is near CHST15, which encodes a sulfotransferase that transports chondroitin sulfate, and MIIP, which encodes a protein that inhibits cell migration, according to the research. Two other genetic loci that did not quite reach the cutoff for significance, but were close enough to suggest it, are near TNS3, which regulates cell migration, and TRIM34, which regulates the response to interferon. There are "not a lot of things that increase the risk of illness and death in young women's lives, and post-partum hemorrhage is one of them. This is something that will be very helpful," said Dr. David Dickerson, the section chief of pain medicine at Northshore University Health System in Chicago, who was not involved in this research. If followed up, this research could lead to tests that screen patients for risk of hemorrhage, allowing physicians to triage high-risk patients to centers that may be better-equipped to handle the problem, Dr. Dickerson told Reuters Health by phone. —Rob Goodier Source
