| Increased fetal loss in women with heritable thrombophilia. | |
| | |
MedLine Citation:
|
PMID: 8843809 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: A successful outcome of pregnancy requires an efficient uteroplacental vascular system. Since this system may be compromised by disorders of haemostasis associated with a prothrombotic state, we postulated that maternal thrombophilia might be a risk factor for fetal loss. We studied the relation between heritable thrombophilic defects and fetal loss in a cohort of women with factor V Leiden or deficiency of antithrombin, protein C, or protein S. METHODS: We studied 1384 women enrolled in the European Prospective Cohort on Thrombophilia (EPCOT). Of 843 women with thrombophilia 571 had 1524 pregnancies; of 541 control women 395 had 1019 pregnancies. The controls were partners of male members of the EPCOT cohort or acquaintances of cases. We analysed the frequencies of miscarriage (fetal loss at or before 28 weeks of gestation) and stillbirth (fetal loss after 28 weeks of gestation) jointly and separately. FINDINGS: The risk of fetal loss was increased in women with thrombophilia (168/571 vs 93/395; odds ratio 1.35 [95% Cl 1.01-1.82]). The odds ratio was higher for stillbirth than for miscarriage (3.6 [1.4-9.4] vs 1.27 [0.94-1.71]). The highest odds ratio for stillbirth was in women with combined defects (14.3 [2.4-86.0]) compared with 5.2 (1.5-18.1) in antithrombin deficiency, 2.3 (0.6-8.3) in protein-C deficiency, 3.3 (1.0-11.3) in protein-S deficiency, and 2.0 (0.5-7.7) with factor V Leiden. The corresponding odds ratios for miscarriage in these subgroups were 0.8 (0.2-3.6), 1.7 (1.0-2.8), 1.4 (0.9-2.2), 1.2 (0.7-1.9), and 0.9 (0.5-1.5). Significantly more pregnancy terminations had been done in women with thrombophilia than in controls (odds ratio 2.9 [1.8-4.8]); this discrepancy was apparent in nine of 11 participating centres and for all thrombophilia subgroups. INTERPRETATION: Women with familial thrombophilia, especially those with combined defects or antithrombin deficiency, have an increased risk of fetal loss, particularly stillbirth. Our findings have important implications for therapy and provide a rationale for clinical trials of thromboprophylaxis for affected women with recurrent fetal loss. |
| | |
Authors:
|
F E Preston; F R Rosendaal; I D Walker; E Briët; E Berntorp; J Conard; J Fontcuberta; M Makris; G Mariani; W Noteboom; I Pabinger; C Legnani; I Scharrer; S Schulman; F J van der Meer |
Related Documents
:
|
19026439 - Low protein z levels, but not the intron f g79a polymorphism, are associated with unexp... 11302479 - Management of heparin allergy during pregnancy with danaparoid. 17997389 - Incidence and risk patterns of venous thromboembolism in pregnancy and puerperium--a re... 15199519 - Pregnancy and deep vein thrombosis. 11770579 - Successful use of danaparoid in treatment of heparin-induced thrombocytopenia during tw... 16026279 - Protein s and congenital protein s deficiency: the most frequent congenital thrombophil... 18752569 - Factor v leiden is associated with pre-eclampsia but not with fetal growth restriction... 11163699 - Effects of sarcoptic mange on the reproductive performance of ewes and transmission of ... 1091899 - Responsibility of the obstetrician to the fetus. ii. influence of prepregnancy weight a... |
Publication Detail:
|
Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Lancet Volume: 348 ISSN: 0140-6736 ISO Abbreviation: Lancet Publication Date: 1996 Oct |
Date Detail:
|
Created Date: 1996-11-08 Completed Date: 1996-11-08 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 2985213R Medline TA: Lancet Country: ENGLAND |
Other Details:
|
Languages: eng Pagination: 913-6 Citation Subset: AIM; IM |
Affiliation:
|
Royal Hallamshire Hospital, Sheffield, UK. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Abortion, Spontaneous
/
epidemiology,
etiology* Adult Aged Aged, 80 and over Antithrombin III Deficiency Blood Coagulation Disorders / complications*, genetics Blood Protein Disorders / complications*, genetics Case-Control Studies Cohort Studies Factor V Deficiency / complications, genetics Female Fetal Death / epidemiology, etiology* Humans Middle Aged Pregnancy Protein C Deficiency Protein S Deficiency / complications, genetics Recurrence Risk Factors |
| Comments/Corrections | |
Comment In:
|
Lancet. 1996 Dec 21-28;348(9043):1734-5
[PMID:
8973447
]
Lancet. 1996 Dec 21-28;348(9043):1734 [PMID: 8973446 ] Lancet. 1996 Dec 21-28;348(9043):1735 [PMID: 8973448 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Excess mortality of unemployed men and women during a period of rapidly increasing unemployment.
Next Document: Post-malaria neurological syndrome.