Abstract
Objective: The purpose of this study was to examine whether women with inherited thrombophilia have an increased risk of developing pregnancy complications. Methods: All singleton pregnancies with known inherited thrombophilia were compared to those without inherited thrombophilia for deliveries during the years 2000–2002 in a tertiary medical center. Data regarding inherited thrombophilia (International Classification of Disease 9th revision, Clinical Modification code 286.3) were available from the perinatal database in our center. Women lacking prenatal care were excluded from the analysis. Stratified analysis, using a multiple logistic regression model, was performed to control for confounders. Results: Out of 32,763 singleton deliveries that occurred during the study period, 0.2% (n=57) of the women were diagnosed with inherited thrombophilia. Using a multivariate analysis, with backward elimination, the following conditions were significantly associated with inherited thrombophilia: previous fetal losses [odds ratio (OR)=5.5; 95% confidence interval (CI) 2.9–10.3; P<0.001], recurrent abortions (OR=9.5; 95% CI 5.5–16.3; P<0.001), fertility treatments (OR=3.7; 95% CI 1.3–10.6; P=0.014), and intrauterine growth restriction (OR=7.2; 95% CI 3.4–15; P<0.001). Perinatal mortality was significantly higher in women with inherited thrombophilia than in those without known thrombophilia 5.3% (3/57) versus 0.6% (477/32,763) P=0.017. However, inherited thrombophilia was not found to be an independent risk factor for perinatal mortality (OR=3.05; 95% CI 0.90–10.3; P<0.073) in a multivariate analysis with perinatal mortality as the outcome variable, controlling for recurrent abortions, IUGR, and gestational age. Conclusion: Inherited thrombophilia, associated with previous fetal losses, recurrent abortions, fertility treatments, and intrauterine growth restriction, was not an independent risk factor for perinatal mortality.
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References
Kupferminc MJ (2003) Thrombophilia and pregnancy. Reprod Biol Endocrinol 1:111
Romero R, Dekker G, Kupferminc M, Saade G, Livingston J, Peaceman A, Mazor M, Yoon BH, Espinoza J, Chaiworapongsa T, Gomez R, Arias F, Sibai B (2002) Can heparin prevent adverse pregnancy outcome? J Matern Fetal Neonatal Med 12(1):1–8
Kupferminc MJ, Fait G, Many A, Gordon D, Eldor A, Lessing JB (2000) Severe preeclampsia and high frequency of genetic thrombophilic mutations. Obstet Gynecol 96:45–49
Dizon-Townson DS, Nelson LM, Easton K, Ward K (1996) The factor V Leiden mutation may predispose women to severe preeclampsia. Am J Obstet Gynecol 175:902–905
Weiner-Megnagi Z, Ben-Shlomo I, Goldberg Y, Shalev E (1998) Resistance to activated protein C and the Leiden mutation: high prevalence in patients with abruptio placentae. Am J Obstet Gynecol 179:1565–1567
Peeters LLH (2001) Thrombophilia and fetal growth restriction. Eur J Obstet Gynecol Reprod Biol 95:202–205
Verspyck E, Borg JY, Le Cam-Duchez V, Goffinet F, Degre S, Fournet P, Marpeau L (2004) Thrombophilia and fetal growth restriction. Eur J Obstet Gynecol Reprod Biol 113:36–40
Preston FE, Rosendaal FR, Walker ID, Briet E, Berntorp E, Conard J, Fontcuberta J, Makris M, Mariani G, Noteboom W, Pabinger I, Legnani C, Scharrer I, Schulman S, van der Meer FJ (1996) Increased fetal loss in women with heritable thrombophilia. Lancet 348:913–916
Dudding TE, Attia J (2004) The association between adverse pregnancy outcomes and maternal factor V Leiden genotype: a meta-analysis. Thromb Haemost 91:700–711
Vossen CY, Preston FE, Conard J, Fontcuberta J, Makris M, van der Meer FJ, Pabinger I, Palareti G, Scharrer I, Souto JC, Svensson P, Walker ID, Rosendaal FR (2004) Hereditary thrombophilia and fetal loss: a prospective follow-up study. J Thromb Haemost 2:592–596
Sheiner E, Levy A, Katz M, Mazor M (2005) Pregnancy outcome following recurrent spontaneous abortions. Eur J Obstet Gynecol Reprod Biol 118(1):61–65
Rai R, Shelbak A, Cohen H, Bakos M, Holmes Z, Marriott K, Regan L (2001) Factor V Leiden and acquired protein C resistance among 1000 women with recurrent miscarriage. Hum Reprod 16:961–965
Raziel A, Kornberg Y, Friedler S, Schachter M, Sela BA, Ron-El R (2001) Hypercoagulable thrombophilic defects and hyperhomocysteinemia in patients with recurrent pregnancy loss. Am J Reprod Immunol 46:65–71
Livingston JC, Barton JR, Park V, Haddad B, Phillips O, Sibai BM (2001) Maternal and fetal inherited thrombophilias are not related to the development of severe preeclampsia. Am J Obstet Gynecol 185:153–157
Infante-Rivard C, Rivard GE, Yotov WV, Genin E, Guiguet M, Weinberg C, Gauther R, Foeli-Fonseca JC (2002) Absence of association of thrombophilia polymorphisms with intrauterine growth restriction. N Engl J Med 347:19–25
McCowan LM, Craigie S, Taylor RS, Ward C, McLintock C, North RA (2003) Inherited thrombophilias are not increased in “idiopathic” small-for-gestational-age pregnancies. Am J Obstet Gynecol 188:981–985
Alfirevic Z, Mousa HA, Martlew V, Briscoe L, Perez-Casal M, Toh CH (2001) Postnatal screening for thrombophilia in women with severe pregnancy complications. Obstet Gynecol 97:753–759
Rasmussen A, Ravn P (2004) High frequency of congenital thrombophilia in women with pathological pregnancies? Acta Obstet Gynecol Scand 83:808–817
Eldor A (2001) Thrombophilia, thrombosis and pregnancy. Thromb Haemost 86:104–111
Kupferminc MJ, Eldor A, Steinman N, Many A, Bar-Am A, Jaffa A, Fair G, Lessing FB (1999) Increased frequency of genetic thrombophilia in women with complications of pregnancy. N Engl J Med 340:9–13
Many A, Schreiber L, Rosner S, Lessing JB, Eldora A, Kupferminc MJ (2001) Pathologic features of the placenta in women with severe pregnancy complications and thrombophilia. Obstetric Gynecol 98:1041–1044
Mousa HA, Alfirevic Z (2001) Thrombophilia and adverse pregnancy outcome. Croat Med J 42:135–145
Rey E, Kahn SR, David M, Shrier I (2003) Thrombophilic disorders and fetal loss: a meta-analysis. Lancet 361:901–908
Many A, Elad R, Yaron Y, Eldor A, Lessing JB, Kupferminc MJ (2002) Third-trimester unexplained intrauterine fetal death is associated with inherited thrombophilia. Obstet Gynecol 99:684–687
Kujovich JL (2004) Thrombophilia and pregnancy complications. Am J Obstet Gynecol 191:412–424
Martinelli I, Taioli E, Cetin I, Marinoni A, Gerosa S, Villa MV, Bozzo M, Mannucci PM (2000) Mutations in coagulation factors in women with unexplained late fetal loss. N Engl J Med 343:1015–1018
Weiner Z, Beck-Fruchter R, Weiss A, Hujirat Y, Shalev E, Shalev SA (2004) Thrombophilia and stillbirth: possible connection by intrauterine growth restriction. BJOG 111:780–783
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Weintraub, A.Y., Sheiner, E., Levy, A. et al. Pregnancy complications in women with inherited thrombophilia. Arch Gynecol Obstet 274, 125–129 (2006). https://doi.org/10.1007/s00404-006-0133-3
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DOI: https://doi.org/10.1007/s00404-006-0133-3