The Risk of Fetal Loss in Family Members of Probands with Factor V Leiden Mutation

Tormene, Daniela; Simioni, Paolo; Prandoni, Paolo; Luni, Sonia; Innella, Barbara; Sabbion, Paola; Girolami, Antonio

doi:10.1055/s-0037-1614367

Cited by 55 publications

(32 citation statements)

References 16 publications

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“…27 A direct comparison of the present study with data from the literature is not possible, because the design of the studies is different. In a large retrospective study of carriers and noncarriers of the factor V:R506Q, Meinardi et al 28 found a higher risk, whereas Tormene et al 29 and Balasch et al 30 did not find a higher rate of early miscarriage in carriers. Dizon-Townson et al 15 found a similarly low prevalence of factor V:R506Q mutation in couples with and without a history of recurrent miscarriage.…”

Section: Discussionmentioning

confidence: 96%

Preeclampsia and Fetal Loss in Women With a History of Venous Thromboembolism

Pabinger

Grafenhofer

Kaider

et al. 2001

ATVB

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Abstract-A higher prevalence of risk factors for venous thromboembolism (VTE) has been found in women with preeclampsia and fetal loss. We investigated whether women with a history of VTE have a higher prevalence of pregnancy-associated complications compared with control subjects. In 395 patients with a history of VTE and in 313 control women, the prevalence of complications during pregnancy and the mean birth weight of viable infants were evaluated. The prevalence of pregnancy-induced hypertension and preeclampsia was higher in patients (5.1% and 3.0%, respectively) compared with control subjects (1.3% each). The odds ratio was 4.13 for pregnancyinduced hypertension (95% CI 1.4 to 12.22, Pϭ0.0058) and 2.43 for preeclampsia (95% CI 0.78 to 7.6, Pϭ0.133). Stillbirth was slightly more frequent in patients (4.3%) than in control subjects (3.2%); the difference was not statistically significant. Miscarriage was equally frequent in patients (21.8%) and control subjects (21.3%). The birth weight of viable infants born to patients was, on average, 109 g lower than that of the infants born to the control subjects (Pϭ0.014) after adjustment for the mother's body mass index. Our study demonstrates that women with a predisposition to VTE have, overall, a good chance for a successful pregnancy outcome. However, the findings from our study support the assumption that a predisposition to venous thrombosis is associated with a higher risk for complications during pregnancy and lower infant birth weight. Key Words: venous thromboembolism Ⅲ pregnancy Ⅲ preeclampsia Ⅲ fetal loss Ⅲ birth weight C omplications of pregnancy, such as preeclampsia and fetal loss, are considered to result from underperfusion of the placenta due to structural and occlusive changes, including thrombosis of the placental vessels. 1 Recently, a number of studies were published in which a higher prevalence of genetic or acquired risk factors for thrombosis was found in women with preeclampsia and/or fetal loss compared with control subjects. [2][3][4][5][6][7] Preeclampsia is a pregnancy-related disorder characterized by increased blood pressure and proteinuria occurring in the second or third trimester of pregnancy and is one of the main causes of maternal and fetal morbidity and mortality. The cause of preeclampsia itself is most probably multifactorial. Genetic factors seem to play an important role, inasmuch as studies have demonstrated a certain familial predisposition. 8 Among other causes, thrombophilia has gained major attention as a risk factor for preeclampsia in recent years. In several case-control studies, 2,5,9,10 a higher prevalence of risk factors for thrombosis, especially the factor V Leiden mutation 11 and the G20210A prothrombin gene variation, 12 has been demonstrated in cases. Other authors 13 do not confirm these data. If the pathogeneses of venous thromboembolism (VTE) and preeclampsia share similar mechanisms, it may be expected that women with a history of VTE are at an increased risk for these complications during pregnancy.Data ...

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Section: Discussionmentioning

confidence: 96%

Preeclampsia and Fetal Loss in Women With a History of Venous Thromboembolism

Pabinger

Grafenhofer

Kaider

et al. 2001

ATVB

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“…The risk for fetal loss is greater in homozygotes than in heterozygotes with FVL 21 and in female siblings of thrombophilic women with FVL. 22 Women with thrombophilia have an increased percentage of losses at later stages of gestation. 13 Activated protein C resistance in the absence of FVL has also been associated with pregnancy loss.…”

Section: Discussionmentioning

confidence: 99%

Clinical management of thrombophilia-related placental vascular complications

Brenner¹

2004

Blood

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“…151,243,[254][255][256][257][258][259][260][261][262][263][264][265][266][267][268] The association between inherited thrombophilic disorders and miscarriage, fi rst observed in women from families with venous thrombosis, has been confi rmed in many studies. 151,228,[269][270][271][272][273][274][275][276][277] A single late fetal aspirin alone (RR, 0.78; 95% CI, 0.39-1.57). 252,284 Similar results were obtained when LMWH and aspirin was compared with IV g -globulin (RR, 0.37; 95% CI, 0.12-1.16).…”

Section: Risk Of Pregnancy Complications In Women With Thrombophiliamentioning

confidence: 99%

VTE, Thrombophilia, Antithrombotic Therapy, and Pregnancy

Bates

Greer

Middeldorp

et al. 2012

Chest

1,286

591

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Summary of RecommendationsNote on Shaded Text: Throughout this guideline, shading is used within the summary of recommendations sections to indicate recommendations that are newly added or have been changed since the publication of Antithrombotic and Thrombolytic Therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Recommendations that remain unchanged are not shaded. Abbreviations: APLA 5 antiphospholipid antibody; aPPT 5 activated partial thromboplastin time; HIT 5 heparin-induced thrombocytopenia; INR 5 international normalized ratio; LMWH 5 low-molecular-weight heparin; NNT 5 number needed to treat; PE 5 pulmonary embolism; RR 5 risk ratio; UFH 5 unfractionated heparin

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The Risk of Fetal Loss in Family Members of Probands with Factor V Leiden Mutation

Cited by 55 publications

References 16 publications

Preeclampsia and Fetal Loss in Women With a History of Venous Thromboembolism

Preeclampsia and Fetal Loss in Women With a History of Venous Thromboembolism

Clinical management of thrombophilia-related placental vascular complications

VTE, Thrombophilia, Antithrombotic Therapy, and Pregnancy

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