Document Detail

Thrombophilia in pregnancy: a systematic review.
MedLine Citation:
PMID:  16398652     Owner:  NLM     Status:  MEDLINE    
Growing evidence suggests that thrombophilia is associated with venous thromboembolism (VTE) and adverse pregnancy outcomes. However, methodological limitations have made it difficult to obtain a clear overview of the overall risks. We conducted a systematic review to determine the risk of VTE and adverse pregnancy outcomes associated with thrombophilia in pregnancy. The effectiveness of prophylactic interventions during pregnancy was also evaluated. Major electronic databases were searched, relevant data abstracted and study quality assessed by two independent reviewers. Odds ratios (ORs) stratified by thrombophilia type were calculated for each outcome. A total of 79 studies were included in our review. The risks for individual thrombophilic defects were determined for VTE (ORs, 0.74-34.40); early pregnancy loss (ORs, 1.40-6.25); late pregnancy loss (ORs, 1.31-20.09); pre-eclampsia (ORs, 1.37-3.49); placental abruption (ORs, 1.42-7.71) and intrauterine growth restriction (ORs, 1.24-2.92). Low-dose aspirin plus heparin was the most effective in preventing pregnancy loss in thrombophilic women (OR, 1.62). Our findings confirm that women with thrombophilia are at risk of developing VTE and complications in pregnancy. However, despite the increase in relative risk, the absolute risk of VTE and adverse outcomes remains low. There is also a lack of controlled trials of antithrombotic intervention to prevent pregnancy complications. Thus, at present, universal screening for thrombophilia in pregnancy cannot be justified clinically.
L Robertson; O Wu; P Langhorne; S Twaddle; P Clark; G D O Lowe; I D Walker; M Greaves; I Brenkel; L Regan; I A Greer;
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  British journal of haematology     Volume:  132     ISSN:  0007-1048     ISO Abbreviation:  Br. J. Haematol.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-09     Completed Date:  2006-02-06     Revised Date:  2009-06-26    
Medline Journal Info:
Nlm Unique ID:  0372544     Medline TA:  Br J Haematol     Country:  England    
Other Details:
Languages:  eng     Pagination:  171-96     Citation Subset:  IM    
Department of Obstetrics and Gynaecology, University of Glasgow, UK.
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MeSH Terms
Fetal Death / etiology,  prevention & control
Pre-Eclampsia / etiology
Pregnancy Complications, Hematologic*
Pregnancy Outcome
Thrombophilia / complications*
Venous Thrombosis / etiology

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