Effect of hemostatic risk factors on the individual probability of thrombosis during pregnancy and the puerperium

Andrea Gerhardt; Rüdiger E. Scharf; Rainer B. Zotz

doi:10.1055/s-0037-1613602

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2003; 90(01): 77-85
DOI: 10.1055/s-0037-1613602

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Effect of hemostatic risk factors on the individual probability of thrombosis during pregnancy and the puerperium

Andrea Gerhardt

¹Department of Hemostasis and Transfusion Medicine, Heinrich Heine University Medical Center, Dusseldorf, Germany

,

Rüdiger E. Scharf

¹Department of Hemostasis and Transfusion Medicine, Heinrich Heine University Medical Center, Dusseldorf, Germany

,

Rainer B. Zotz

¹Department of Hemostasis and Transfusion Medicine, Heinrich Heine University Medical Center, Dusseldorf, Germany

› Institutsangaben

Abstract

Summary

In a retrospective study of 190 women with a first history of venous thromboembolism during pregnancy and the puerperium and 190 age-matched women with at least one prior pregnancy and no history of venous thromboembolism, the individual probability of thrombosis was determined. Assuming an overall risk of 1 in 1500 pregnancies, the probability of pregnancy-related thrombosis in carriers of homozygous factor V Leiden was 1 in 80 (odds ratio 20.6, p=0.005) and among carriers of combined heterozygous factor V Leiden and heterozygous G20210A mutation in the prothrombin gene 1 in 20 (odds ratio 88, p<0.001). The probability of thrombosis per pregnancy among women with elevated levels of factor VIII:C (>172 % activity) was 1 in 385 (odds ratio 4.5, p<0.001) and among those with increased levels of von Willebrand factor antigen (>190 %) 1 in 435 (odds ratio 4.0, p=0.002), independent of elevated factor VIII:C levels. The high prevalence of combined and homozygous defects of hemostatic components (21.6%) in patients as compared with normal women (0.86%) supports the concept that venous thromboembolism is a multicausal disorder.

Keywords

Pregnancy - venous thrombosis - risk factors - pulmonary embolism

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Referenzen

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