What is the clinical evidence from this study?

Study design: Cohort. Population: Hereditary deficiencies of antithrombin, protein C or protein S (n=376). Intervention: Anticoagulant treatment (thromboprophylaxis) vs. No thromboprophylaxis. Primary outcome: Fetal loss (RR 0.07, 95% CI 0.001-0.7, p=0.02).

What question did this study set out to answer?

To evaluate whether anticoagulant thromboprophylaxis during pregnancy reduces the elevated rate of fetal loss in women with hereditary antithrombin, protein C, or protein S deficiency.

January 11, 2007British Journal of HaematologyOpen Access

Reduction of high fetal loss rate by anticoagulant treatment during pregnancy in antithrombin, protein C or protein S deficient women

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Key result

Anticoagulant treatment during pregnancy in women with hereditary thrombophilia significantly reduced fetal loss compared to no treatment (0% vs 45%; adjusted RR 0.07, 95% CI 0.001-0.7; P=0.02).

Why the study?

Does anticoagulant treatment during pregnancy reduce fetal loss in women with hereditary deficiencies of antithrombin, protein C or protein S?

Population

55 eligible women analyzing the outcome of their first pregnancy, drawn from an observational family cohort…

Comparison

Anticoagulant treatment during pregnancy vs No thromboprophylaxis during pregnancy

Design

Cohort

Follow-up

Outcome of first pregnancy

Authors

NFNienke FolkeringaUniversity Medical Center Groningen JBJan Leendert P. BrouwerInteruniversity Center for Social Science Theory and Methodology FKFleurisca J. KortewegMartini Ziekenhuis

Discussion

Member takes

Implication

May support anticoagulation in this high-risk group; leaves open need for randomized confirmation.

Key Points

To evaluate whether anticoagulant thromboprophylaxis during pregnancy reduces the elevated rate of fetal loss in women with hereditary antithrombin, protein C, or protein S deficiency.
Prospective observational family cohort study evaluating pregnancy outcomes in 55 eligible women from a cohort of 376 women (50 probands with venous thromboembolism and 326 relatives).
Compared first-pregnancy outcomes between women who received anticoagulant thromboprophylaxis and those who did not across 37 deficient and 18 non-deficient individuals.
Fetal loss rates were 0% in deficient women receiving thromboprophylaxis versus 45% in untreated deficient women (P = 0.001) and 7% in untreated non-deficient women (P = 0.37).
Anticoagulant thromboprophylaxis significantly reduced the risk of fetal loss compared with no treatment (adjusted RR 0.07, 95% CI 0.001–0.7; P = 0.02).

Study Design

Type

Cohort (n=376)

Structured PICO

Does anticoagulant treatment during pregnancy reduce fetal loss in women with hereditary deficiencies of antithrombin, protein C or protein S?

Population

376 women (50 probands and 326 relatives) with or without hereditary thrombophilia, with first pregnancy outcomes analyzed in 55 eligible women.

Exposure

Anticoagulant treatment (thromboprophylaxis) during pregnancy

Comparator

No thromboprophylaxis during pregnancy

Outcome

Fetal loss ratehard clinical

Main Result

Relative Risk: 0.07 (95% CI 0.001–0.7)

Absolute Event Rate: 0% vs 45%

p-value: p=0.02

Anticoagulant treatment during pregnancy significantly reduces the high fetal loss rate in women with hereditary deficiencies of antithrombin, protein C, or protein S.

Cite This Study

Folkeringa et al. (2007) conducted a cohort in Hereditary deficiencies of antithrombin, protein C or protein S (n=376). Anticoagulant treatment (thromboprophylaxis) vs. No thromboprophylaxis was evaluated on Fetal loss (RR 0.07, 95% CI 0.001-0.7, p=0.02). Anticoagulant treatment during pregnancy in women with hereditary thrombophilia significantly reduced fetal loss compared to no treatment (0% vs 45%; adjusted RR 0.07, 95% CI 0.001-0.7; P=0.02).

synapsesocial.com/papers/6a93bf1d744b618ad237ecf7 https://doi.org/10.1111/j.1365-2141.2006.06480.x

Topics

Anticoagulation in AF

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Reduction of high fetal loss rate by anticoagulant treatment during pregnancy in antithrombin, protein C or protein S deficient women

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Reduction of high fetal loss rate by anticoagulant treatment during pregnancy in antithrombin, protein C or protein S deficient women

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

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