Activated Protein C Resistance (FV:Q506) and Pregnancy

Pelle G. Lindqvist; Peter J. Svensson; Karel Maršál; Lars Grennert; Marie Luterkort; Björn Dahlbäck

doi:10.1055/s-0037-1614519

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1999; 81(04): 532-537
DOI: 10.1055/s-0037-1614519

Rapid Communication

Schattauer GmbH

Activated Protein C Resistance (FV:Q⁵⁰⁶) and Pregnancy

Pelle G. Lindqvist

¹From the Departments of Obstetrics and Gynecology, or Lund, Sweden

,

Peter J. Svensson

²Department of Medicine, or Lund, Sweden

⁴Department of Coagulation Disorders, Lund University, University Hospital, Malmö, or Lund, Sweden

,

Karel Maršál

³From the Departments of Obstetrics and Gynecology, or Lund, Sweden

,

Lars Grennert

¹From the Departments of Obstetrics and Gynecology, or Lund, Sweden

,

Marie Luterkort

⁵Slottsstaden Group Practice. Malmö, Sweden

,

Björn Dahlbäck

⁴Department of Coagulation Disorders, Lund University, University Hospital, Malmö, or Lund, Sweden

› Author Affiliations

Abstract

Summary

Activated protein C (APC) resistance, due to a point mutation in the factor V gene (FV:Q⁵⁰⁶), is a major risk factor for venous thromboembolism. To determine the prevalence of APC resistance in a large series of pregnant women, and to elucidate its obstetric consequences, we performed a prospective study in Malmö, Sweden, comprising 2,480 women enrolled in early pregnancy. The presence of APC resistance (the FV:Q⁵⁰⁶ allele) was determined. The women were interviewed about their medical histories including venous thromboembolic events (VTE) in relatives. The outcome variables were the VTE rate, intrapartum blood loss, and the prevalence of selected pregnancy complications such as fetal loss, pre-eclampsia, and intrauterine growth retardation.

The overall prevalence of APC resistance was 11% (270/2480). The APC-resistant subgroup did not differ significantly from the non-APC-resistant subgroup in terms of pregnancy complications, but was characterized by an 8-fold higher risk of VTE (3/270 vs. 3/2210), a lower rate of profuse intrapartum haemorrhage (3.7% vs. 7.9%) (p = 0.02), and less intrapartum blood loss (340 ml vs. 361 ml) (p = 0.04). Despite the high prevalence of APC resistance in this series of gravidae (11%), its presence was unrelated to adverse pregnancy outcome apart from an 8-fold increased risk of VTE.

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References

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