Prevalence and Clinical Significance of Thrombophilia in Adverse Pregnancy Outcomes Among Sudanese Women: A Cross-sectional Study

Background: Thrombophilia has been linked to adverse obstetric outcomes, but data from Sudan are limited. Methods: We performed a hospital-based cross-sectional study of 166 women at Omdurman Maternity Hospital (2019–2021). Exposures were Factor V Leiden (FVL), protein C (PC), and free protein S (PS). Outcomes were early loss (<12 weeks) and late loss (12–24 weeks) versus no loss. Associations were assessed with χ²/Fisher’s exact tests and multinomial logistic regression. Results: Any thrombophilia was present in 39.8% (66/166). Low PS was most frequent (31.3%). Low PS was associated with pregnancy loss overall (P = 0.003) and remained independently associated with late loss (adjusted OR = 3.92; 95% CI: 1.30 to 11.88; P = 0.016). FVL (5.4%) and low PC (4.2%) were not independently associated with loss. Periconceptional hormonal-contraceptive use was associated with early loss (aOR = 5.40; 95% CI: 1.12 to 26.09; P = 0.036); parity was protective for early loss but associated with late loss (aOR = 2.19; 95% CI: 1.39 to 3.44; P < 0.001); and consanguinity showed a borderline association with late loss (aOR = 2.59; 95% CI: 0.93 to 7.23; P = 0.070). Conclusion: In this hospital-based cross-sectional study, low PS was common and was associated with pregnancy loss, particularly late loss. These findings are hypothesisgenerating; cross-sectional data cannot establish temporality. Prospective studies with postpartum confirmation of low PS are needed before routine clinical testing can be recommended.