Thrombophilia risk during pregnancy was associated with a significantly higher rate of obstetric complications compared to matched controls (68.4% vs 37.5%; OR 3.6; 95% CI 1.42-9.21; P<0.001).
Cohort (n=78)
No
Does thrombophilia risk increase the incidence of obstetric complications in pregnant women, and does anticoagulation therapy improve outcomes?
Pregnant women with thrombophilia risk have a significantly higher incidence of obstetric complications, which may be mitigated by the strict application of full-dose anticoagulation therapy.
Odds Ratio: 3.6 (95% CI 1.42–9.21)
Absolute Event Rate: 68.4% vs 37.5%
p-value: p=< 0.001
Pregnancy is a hypercoagulable state associated with an increased risk of venous thromboembolic disease (VTE). We retrospectively studied 38 Caucasian pregnant women with thrombophilia risk and compared their obstetric outcomes with a matched cohort without known thrombophilia risk during the period between January 2007 and December 2010. There were (2) cases with factor V Leiden, (6) prothrombin gene mutation, (1) antithrombin III deficiency, (2) protein C deficiency, (3) protein S deficiency, (10) MTHFR mutation, (7) anti-cardiolipin antibodies, and (1) lupus anticoagulant. Patients without thrombophilia who presented with recurrent unprovoked VTE were considered as high risk (6 cases). Most patients received anticoagulation (34/38) with aspirin only (6), enoxaparin (27), and warfarin (1). Twenty-six out of thirty-eight pregnant women (68.4%) with an increased risk of thrombophilia experienced one or more obstetric complications defined as hypertension, preeclampsia, placenta abruptio, VTE, and oligohydramnios, compared with 15 out of 40 (37.5%) pregnant women in the control group (OR 3.6; 95% CI 1.42, 9.21, P < 0.001). The incidence of obstetric complications was significantly higher in the thrombophilia group compared to the controls. However, these complications were the lowest among patients who received full-dose anticoagulation. Our study suggests that strict application of anticoagulation therapy for thrombophilia of pregnancy is associated with an improved pregnancy outcome. The study was registered in the Australian and New Zealand Clinical Trials Registry under ACTRN12612001094864.
Khalafallah et al. (Mon,) conducted a cohort in Pregnancy with thrombophilia risk (n=78). Thrombophilia risk vs. No known thrombophilia risk was evaluated on Obstetric complications (hypertension, preeclampsia, placenta abruptio, VTE, and oligohydramnios) (OR 3.6, 95% CI 1.42-9.21, p=< 0.001). Thrombophilia risk during pregnancy was associated with a significantly higher rate of obstetric complications compared to matched controls (68.4% vs 37.5%; OR 3.6; 95% CI 1.42-9.21; P<0.001).