Thrombophilia risk factors are associated with intrauterine foetal death and pregnancy‐related venous thromboembolism

Abstract

Pregnancy in healthy women is accompanied by hypercoagulable changes that may interact with thrombophilia risk factors and threaten pregnancy. However, the literature on this issue is conflicting. In investigating the relationship between pregnancy‐associated complications and the presence of thrombophilia risk factors, we studied the records of 414 women who had been examined for inherited and acquired thrombophilia in the period 1996 to 2006 because of pregnancy‐associated complications. Of a total of 885 pregnancies among the women, 397 were recorded as foetal loss/intrauterine foetal death during the first (62 %), second (25 %) or third trimester (13 %). One‐hundred‐and‐two (25 %) women had had a thromboembolic event during one of their pregnancies, and 98 (24 %) had had pre‐eclampsia on at least one occasion. Intrauterine growth restriction was found in 105 (25 %) of the women, and 29 (7 %) suffered placental abruption. We found that 120 (29 %) women had at least one thrombophilia risk factor. Factor V Leiden heterozygosity was the most common thrombophilia factor (n = 52), mostly linked with the risk of venous thromboembolism during pregnancy or postpartum and to foetal death during the second or third trimester. Fifty‐three (13 %) women had antiphospholipid antibodies (lupus anticoagulant and/or anti‐β2‐glycoprotein 1 antibodies) mainly associated with the risk of spontaneous abortion during the first trimester. In conclusion, thrombophilia was found to be considerably more common in women with pregnancy‐associated complications in comparison with the general population, and most frequently in conjunction with venous thromboembolism during pregnancy and the postpartum period.

• Intrauterine growth restriction
• pre‐eclampsia
• pregnancy complications
• pregnancy loss
• thrombophilia
• venous thromboembolism