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Is thrombophilia a risk factor for placenta-mediated pregnancy complications?

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Abstract

Purpose

To determine if thrombophilia is a risk factor for placenta-mediated pregnancy complications (PMPC) (i.e., preeclampsia, intrauterine growth restriction (IUGR), placental abruption, intrauterine fetal death and recurrent pregnancy loss).

Methods

A 5-year retrospective cohort study. Ongoing pregnancies in women with an antecedent PMPC with thrombophilia were compared with the pregnancies in similar women without thrombophilia. The main outcome measures were mean birth weight deviations, corrected for gestational age, and recurrence of PMPC. Low-molecular-weight heparin (LMWH) was employed for thromboprophylaxis only. Mann–Whitney’s, Fisher’s and Chi-square tests were employed for comparison.

Results

PMPC recurred in 10/43 (23 %) in the thrombophilia group and in 7/41 (17 %) in the non-thrombophilia group, P < 0.059. The mean birth weight deviations were not significantly different either: −7.2 versus −3.0 %, respectively. LMWH, as could be expected, was used more often in thrombophilia patients (39/43 vs. 10/41, P < 0.001).

Conclusion

Thrombophilia does hardly increase the risk of IUGR/PMPC or if so, it can be prevented by LMWH.

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Notes

  1. (1) Preeclampsia and IUFD, (2) preeclampsia and IUGR and, (3) IUGR and IUFD.

References

  1. Duhl AJ, Paidas MJ, Ural SH, Branch W, Casele H, Cox-Gill J et al, The Pregnancy and Thrombosis Working Group (2007) Antithrombotic therapy and pregnancy: consensus report and recommendations for prevention and treatment of venous thromboembolism and adverse pregnancy outcomes. Am J Obstet Gynecol 197: 457e1–457e21

    Google Scholar 

  2. Rodger MA, Paidas M (2007) Do thrombophilia cause placenta-mediated pregnancy complications? Sem Thromb Hem 33(6):597–603

    Article  Google Scholar 

  3. Mello G, Paretti E, Marozio L, Pizzi C, Lojacono A, Frusca T et al (2005) Thrombophilia is significantly associated with severe preeclampsia. Hypertension 46:1270–1274

    Article  PubMed  CAS  Google Scholar 

  4. Howley HEA, Walker M, Rodger MA (2005) A systematic review of the association between factor V Leiden or prothrombin gene variant and intrauterine growth restriction. Am J Obstet Gynecol 192:694–708

    Article  PubMed  CAS  Google Scholar 

  5. Alfirevic Z, Roberts D, Martlev V (2002) How strong is the association between maternal thrombophilia and adverse pregnancy outcome? A systematic review. Eur J Obstet Gynecol Reprod Biol 101:4–6

    Article  Google Scholar 

  6. Lindqvist PG, Svensson P, Marsal K, Grennert L, Luterkort M, Dählback B (1999) Activated protein C resistance (FV: Q 506) and pregnancy. J Thromb Haemost 81:532–537

    CAS  Google Scholar 

  7. Rodger M, Betancourt MT, Clark P, Dizon-Townson D, Said J, Seligson U et al (2010) The association of factor V Leiden and prothrombin gene mutation and placenta-mediated pregnancy complications: a systematic review and meta-analysis of prospective cohort studies. Plos Med 7(6):1–12 (e1000292)

    Google Scholar 

  8. Marsal K, Persson P-H, Larsen T, Lilja H, Selbing A, Sultan Bl (1996) Intrauterine growth curves based on ultrasonically estimated fetal weights. Acta Paediatr 85:843–848

    Article  PubMed  CAS  Google Scholar 

  9. Marsal K (2009) Obstetric management of intrauterine growth restriction. Best Pract Res Clin Obstet Gynecol 23:857–870

    Article  Google Scholar 

  10. McCowan L, Horgan PR (2009) Risk factors for small for gestational age infants. Best Pract Res Clin Obstet Gynecol 23:779–793

    Article  Google Scholar 

  11. Barton JR, Sibai BM (2008) Prediction and prevention of recurrent preeclampsia. Obstet Gynecol 112(2–1):359–372

    Article  PubMed  Google Scholar 

  12. Bhattacharya S, Prescott GJ, Black M, Shetty A (2010) Recurrence risk of stillbirth in a second pregnancy. BJOG 117:1243–1247

    Article  PubMed  CAS  Google Scholar 

  13. Tikkanen M (2011) Placental abruption: epidemiology, risk factors and consequences. Acta Obstet Gynecol Scand 90(2):140–149

    Article  PubMed  Google Scholar 

  14. Cnossen JS, Morris RK, Riet G, Mol BWJ, van der Post JAM, Comarasamy A et al (2008) Use of uterine artery Doppler ultrasonography to predict preeclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis. CMAJ 178(8):701–711

    PubMed  Google Scholar 

  15. Lindquist PG, Molin J (2005) Does antenatal identification of small-for-gestational age significantly improve their outcome? Ultrasound Obstet Gynecol 25:258–264

    Article  Google Scholar 

  16. D`Ippolito S, Ortiz AS, Veglia M, Tersigmi C, di Simone N (2011) Low molecular weight heparin in obstetric care: a review of the literature. Reprod Sci 18(7):602–613

    Article  CAS  Google Scholar 

  17. Kupherminc M, Rimon E, Many A, Maslovitz S, Lessing JB, Gamzu R (2011) Low molecular weight heparin versus no treatment in women with previous severe pregnancy complications and placental findings without thrombophilia. Blood Coagul Fibrinolysis 22:123–126

    Article  Google Scholar 

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Acknowledgments

We thank Henrik Andersen MD, who contributed data to the study. This study was not funded.

Conflict of interest

The authors declare no conflict of interest.

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Correspondence to Elise Hoffmann.

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Hoffmann, E., Hedlund, E., Perin, T. et al. Is thrombophilia a risk factor for placenta-mediated pregnancy complications?. Arch Gynecol Obstet 286, 585–589 (2012). https://doi.org/10.1007/s00404-012-2342-2

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  • DOI: https://doi.org/10.1007/s00404-012-2342-2

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