ABO血型与妊娠并发症的关系

Relationship Between ABO Blood Group and Pregnancy Complications

ABO血型系统是临床上最常用的血型分类,其抗原(A、B和H决定簇)是在红细胞和其他多种细胞系和组织中表达的复杂碳水化合物分子,由位于9号染色体(9q34.1-q34.2)上的ABO基因座决定。ABO血型与许多人类疾病的发展有关,如心血管疾病、感染性疾病和肿瘤性疾病等,孕妇ABO血型与各种妊娠并发症之间的关系成为产科医生近来研究的热点,包括子痫前期(PE)及其相关疾病、妊娠相关静脉血栓栓塞症(PA-VTE)、妊娠期糖尿病(GDM)和产后出血(PPH)等。本文对ABO血型与这些妊娠并发症的关系研究进行回顾,现有证据大多支持以下观点:(1)O血型是PE患病的保护因素,AB血型增加了PE的患病风险;(2)非O血型比O血型更容易发生PA-VTE;(3)O血型或AB血型可能与GDM的发生有关;(4)O血型较非O血型发生PPH的风险更高。未来需要进行更深入的流行病学和遗传学研究来证实,这些发现可为产科疾病的发病机制研究提供新的思路,为产科医生对相关疾病的防治提供理论依据。

ABO blood group system is the most commonly used blood group classification system in clinic practice.The relevant antigens,A,B and H determinants,are complex carbohydrate molecules that are expressed in red blood cells and other cell lines and tissues.These antigens are determined by the ABO locus located on chromosome 9(9q34.1-q34.2).ABO blood group is associated with the development of many human diseases,e.g.,cardiovascular diseases,infectious diseases,and tumors.The relationship between the ABO blood group of pregnant women and various pregnancy complications,including preeclampsia(PE)and the related diseases,pregnancy associated venous thromboembolism(PA-VTE),gestational diabetes mellitus(GDM),and postpartum hemorrhage(PPH),have become the focus of obstetricians’recent research interest.Herein,we reviewed the relationship between ABO blood group and these pregnancy complications,and found that most of the reported findings supported the following views:1)Blood type O is a protective factor for PE,while blood type AB increases the risk of PE;2)blood types other than O are more prone to PAVTE than blood type O;3)blood type O or blood type AB may be related to the pathogenesis of GDM;4)women of blood type O are at higher risks for PPH than those of other blood types.More in-depth epidemiological and genetic studies are needed to confirm these findings in the future.These findings can provide new ideas for researching into the pathogenesis of obstetric diseases and form the theoretical basis for obstetricians to prevent and treat related diseases.