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Thromb Haemost 2002; 87(05): 791-795
DOI: 10.1055/s-0037-1613085
Review Article
Schattauer GmbH

Inherited Thrombophilia and First Venous Thromboembolism during Pregnancy and Puerperium

Ida Martinelli
1   Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, University of Milan, Italy
,
Valerio De Stefano
2   Department of Hematology, Catholic University of Rome, Italy
,
Emanuela Taioli
3   Epidemiology Unit, IRCCS Maggiore Hospital, University of Milan, Italy
,
Katia Paciaroni
2   Department of Hematology, Catholic University of Rome, Italy
,
Elena Rossi
2   Department of Hematology, Catholic University of Rome, Italy
,
Mannucci Mannuccio Pier
1   Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, University of Milan, Italy
› Author Affiliations
Further Information

Publication History

Received 26 October 2001

Accepted after revision 11 January 2002

Publication Date:
11 December 2017 (online)

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Summary

Venous thromboembolism is a rare but threatening complication of pregnancy. Little conclusive information is available on the actual risk of venous thromboembolism during pregnancy or puerperium in women with inherited thrombophilia, particularly in carriers of factor V Leiden and of the G20210A prothrombin gene mutation. To determine the pregnancy-related and puerperium-related risk of venous thromboembolism in women with inherited thrombophilia, we performed a case-control study on 119 women who had a first episode of deep vein thrombosis and/or pulmonary embolism during pregnancy or puerperium and 232 healthy women who had at least one pregnancy without thrombosis. Inherited thrombophilia was diagnosed in 47 patients (39.5%) and 15 controls (6.5%). The relative risk of venous thromboembolism was 10.6 (95% CI, 5.6-20.4) for heterozygous carriers of factor V Leiden, 2.9 (95% CI, 1.0-8.6) for heterozygous carriers of the prothrombin mutation and 13.1 (95% CI, 5.0-34.2) for those with antithrombin, protein C or protein S deficiency taken together. Sixty-eight of the 119 women (57%) had thrombosis after delivery, confirming the puerperium as a particularly high-risk period. When women were divided into two groups of those with antenatal or postnatal thrombosis, the relative risks associated with each type of inherited thrombophilia were of similar magnitude. In conclusion, women with inherited thrombophilia have an increased risk of venous thromboembolism during pregnancy. Among thrombophilic abnormalities, the prothrombin mutation was the weakest risk factor. Thrombosis occurred more frequently in puerperium than in pregnancy, whether or not thrombophilia was diagnosed.

Keywords

Blood coagulation - factor V Leiden - prothrombin mutation - risk factors
 

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