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October 26, 2017BMJOpen Access

Pregnancy, thrombophilia, and the risk of a first venous thrombosis: systematic review and bayesian meta-analysis

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Why the study?

What is the absolute risk of a first venous thromboembolism during pregnancy and postpartum in women with hereditary thrombophilia?

Population

Pregnant women with hereditary thrombophilia not receiving anticoagulants (36 observational studies included)

Design

Meta-analysis

Follow-up

Pregnancy and postpartum period

Authors

FCF. Nanne CrolesKNKazem NasserinejadJDJohannes J. Duvekot

Discussion

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Overview

Supports targeted VTE prophylaxis for high-risk thrombophilias while avoiding overtreatment in heterozygous carriers.

Structured PICO

What is the absolute risk of a first venous thromboembolism during pregnancy and postpartum in women with hereditary thrombophilia?

P
Population
Pregnant women with hereditary thrombophilia not receiving anticoagulants (36 observational studies included)
I
Intervention
Presence of hereditary thrombophilia (antithrombin deficiency, protein C deficiency, protein S deficiency, factor V Leiden, prothrombin G20210A mutations)
O
Outcome
First venous thromboembolism (VTE) in pregnancy (antepartum and postpartum)hard clinical

High-risk thrombophilias (antithrombin, protein C/S deficiency, homozygous factor V Leiden) warrant consideration for VTE prophylaxis during pregnancy/postpartum, whereas heterozygous mutations generally do not.

Cite This Study

Croles et al. (2017) studied this question.

synapsesocial.com/papers/6a8be2d0effeb02058b1edb8https://doi.org/10.1136/bmj.j4452
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Also Consider

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

  1. 1Hereditary risk factors for thrombophilia and probability of venous thromboembolism during pregnancy and the puerperium2016 · 112 citations
  2. 2Risk of Pregnancy-related Venous Thrombosis in Carriers of Severe Inherited Thrombophilia2001 · 139 citations
  3. 3Prothrombin 20210A Mutation2004 · 109 citations
  4. 4Venous thromboembolism in pregnancy and the puerperium: incidence and additional risk factors from a London perinatal database2001 · 391 citations
  5. 5The Relationship of the Factor V Leiden Mutation and Pregnancy Outcomes for Mother and Fetus2005 · 259 citations