What question did this study set out to answer?

To examine the prevalence of maternal thrombophilic defects among women who experienced severe pregnancy complications compared with healthy controls.

May 1, 2001Obstetrics and Gynecology

Postnatal screening for thrombophilia in women with severe pregnancy complications*1

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Why the study?

Is maternal thrombophilia more prevalent in women with severe pregnancy complications compared to those with uncomplicated pregnancies?

Key Points

To examine the prevalence of maternal thrombophilic defects among women who experienced severe pregnancy complications compared with healthy controls.
Assessed 102 women who experienced severe pregnancy complications (severe preeclampsia/eclampsia, placental abruption, fetal growth restriction, or unexplained stillbirth) and 44 healthy controls with uncomplicated pregnancies.
Tested participants 10 weeks postpartum for factor V Leiden, MTHFR C677T, and G20210A prothrombin gene mutations; protein C, protein S, and antithrombin III deficiencies; and lupus anticoagulant and anticardiolipin antibodies.
Abnormal thrombophilia screens were detected in 53% (54/102) of women with complications compared to 39% (17/44) of controls (OR 1.8; 95% CI 0.87, 3.67).
Specific gene mutations (factor V Leiden, G20210A prothrombin, homozygous MTHFR C677T) were present in 18% of cases versus 16% of controls (OR 1.1; 95% CI 0.44, 2.94), while non-factor V Leiden activated protein C resistance occurred in 26% versus 18% (OR 1.5; 95% CI 0.63, 3.73).
Multiple thrombophilic defects were found in 20% of women with complications compared to 9% of control women (OR 2.4; 95% CI 0.78, 7.61).

Structured PICO

Is maternal thrombophilia more prevalent in women with severe pregnancy complications compared to those with uncomplicated pregnancies?

Population

146 women, including 102 with severe pregnancy complications (severe preeclampsia/eclampsia, placental abruption, fetal growth restriction, and unexplained stillbirth) and 44 healthy women with uncomplicated pregnancies.

Intervention

Thrombophilia screening (tested 10 weeks postpartum for mutations of factor V Leiden, MTHFR C677T, G20210A prothrombin gene; deficiencies of protein C, protein S, antithrombin III; lupus anticoagulant and anticardiolipin antibodies)

Comparator

Healthy women with uncomplicated pregnancies

Outcome

Prevalence of maternal thrombophilia (abnormal thrombophilia screen)surrogate

Maternal thrombophilia was not significantly more common in women with severe pregnancy complications compared to healthy controls, suggesting it may not be a major additional risk factor.

Limitations

Small control group size (aimed for 300 controls but only recruited 44, limiting statistical power)

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Does not support routine thrombophilia screening after pregnancy complications; leaves open targeted evaluation in high-risk subgroups.

Cite This Study

Žarko Alfirević (2001) studied this question.

synapsesocial.com/papers/6a7b6d0902ab7a73dd0354bc https://doi.org/10.1016/s0029-7844(01)01190-5

View Full Paper

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Postnatal screening for thrombophilia in women with severe pregnancy complications*1

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Postnatal screening for thrombophilia in women with severe pregnancy complications*1

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider