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Risk of placenta‐mediated pregnancy complications or pregnancy‐related VTE in VTE‐asymptomatic families of probands with VTE and heterozygosity for factor V Leiden or G20210 prothrombin mutation

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Abstract
Background

Few studies have evaluated the risk of pregnancy‐related adverse events in asymptomatic relatives of probands for VTE and factor V Leiden or the G20210A variant. The antepartum management of this population ranges from antepartum anticoagulation therapy to clinical surveillance.
Objective

To evaluate the risk of placenta‐mediated pregnancy complications and pregnancy‐related VTE in VTE‐asymptomatic families of probands with VTE and who are heterozygous carriers of either factor V Leiden or PTG20210A mutation.
Methods

One hundred and fifty‐eight relatives, who had 415 pregnancies, were retrospectively evaluated. Odds ratios and 95% confidence intervals were calculated to compare pregnancy outcomes between women with and without thrombophilia.
Results

In the factor V Leiden group, 22 placenta‐mediated pregnancy events of 152 pregnancies (14.4%) were reported, compared with 25 adverse events of 172 pregnancies in the G20210A prothrombin group (14.5%) and 13 adverse events of 91 pregnancies in the non‐carrier group (14.2%). Carriers of factor V Leiden or G20210A prothrombin were not associated with a higher risk of pregnancy‐adverse outcomes compared with non‐carriers: OR 1.02 (95% CI, 0.40–2.25) and 1.25 (95% CI, 0.48–3.24), respectively. Four episodes of pregnancy‐associated VTE of 415 pregnancies (0.96%) were recorded. Two episodes of VTE in the G20210A group, one in the factor V Leiden group, and one episode in the non‐carrier group were noted.
Conclusions

In VTE‐asymptomatic relatives of probands with VTE, the presence of factor V Leiden or the G20210A prothrombin mutation in heterozygosis should not lead to a decision to instigate antepartum prophylaxis.
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Document Type: Research Article

Publication date: September 1, 2012

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