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January 1, 1996Thrombosis and Haemostasis

The Risk of Abortion and Stillbirth in Antithrombin-, Protein C-, and Protein S-deficient Women

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Why the study?

Does hereditary deficiency of antithrombin, protein C, or protein S increase the risk of abortion and stillbirth in women?

Population

129 female subjects who had been pregnant at least once and who had a family member with documented venous…

Comparison

Hereditary deficiency of antithrombin, protein… vs Non-deficient female subjects with a similar…

Design

Cohort

Authors

BSBernd Jan SansonAmsterdam UMC Location University of AmsterdamPFPhilip W FriedrichAmsterdam UMC Location University of AmsterdamPSPaolo SimioniUniversity of Padua

Discussion

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Implication

Hereditary deficiencies were associated with higher pregnancy loss rates; leaves open whether targeted anticoagulation improves outcomes.

Key Points

  • To determine whether hereditary deficiencies of natural anticoagulants—antithrombin, protein C, and protein S—increase the risk of miscarriage and stillbirth.
  • Evaluated obstetric history in 129 women with at least one pregnancy and a family member with venous thrombosis linked to antithrombin, protein C, or protein S deficiency.
  • Determined anticoagulant deficiency status among participants following obstetric history assessment.
  • Fetal loss occurred in 22.3% (42/188) of pregnancies in 60 deficient women compared to 11.4% (23/202) of pregnancies in 69 non-deficient women.
  • Women with anticoagulant deficiencies had an elevated risk of abortion and stillbirth per pregnancy compared to non-deficient controls (RR 2.0, 95% CI 1.2–3.3).

Structured PICO

Does hereditary deficiency of antithrombin, protein C, or protein S increase the risk of abortion and stillbirth in women?

P
Population
129 female subjects who had been pregnant at least once and who had a family member with documented venous thrombosis associated with a deficiency of antithrombin (AT), protein C (PC), or protein S (PS)
I
Intervention
Hereditary deficiency of antithrombin (AT), protein C (PC), or protein S (PS)
C
Comparator
Non-deficient female subjects with a similar family history
O
Outcome
Abortion and stillbirth (fetal demise)hard clinical

Women with hereditary deficiencies of antithrombin, protein C, or protein S have a twofold increased risk of abortion and stillbirth compared to non-deficient women.

Cite This Study

Sanson et al. (1996) studied this question.

synapsesocial.com/papers/6a7564ac96d04a2f43f59576https://doi.org/10.1055/s-0038-1650282
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Thrombosis and Pregnancy in Congenital Deficiencies in AT III, Protein C or Protein S: Study of 78 Women1990 · 285 citations
  2. 2Absence of Thrombosis in Subjects with Heterozygous Protein C Deficiency1987 · 528 citations
  3. 3Fetal Demise Associated with Lupus Anticoagulant: Clinical Features and Results of Treatment2010 · 8 citations
  4. 4Absence of the blood-clotting regulator thrombomodulin causes embryonic lethality in mice before development of a functional cardiovascular system.1995 · 246 citations
  5. 5Activated protein C decreases plasminogen activator-inhibitor activity in endothelial cell-conditioned medium1985 · 300 citations